Association Between Admission Serum Albumin and Short-Term Functional Improvement During Inpatient Rehabilitation After Cervical Traumatic Spinal Cord Injury: A Retrospective Cohort Study

Objective To determine whether serum albumin measured at rehabilitation admission is associated with short-term improvement in activities of daily living (ADL) among patients with cervical traumatic spinal cord injury (TSCI). Methods This single-center retrospective cohort study included 106 patients with cervical TSCI admitted for rehabilitation between 2015 and 2021. Serum albumin was measured within 24 h of rehabilitation admission. Functional change was assessed with the 100-point Barthel Index (BI). The primary outcome was ΔBI ≥5; supportive analyses used ΔBI ≥10 and continuous ΔBI. The prespecified core model adjusted for admission BI, time from injury to rehabilitation admission, length of stay, and cervical injury level. Results Sixty-nine patients (65.1%) achieved ΔBI ≥5 and 53 (50.0%) achieved ΔBI ≥10. Mean admission serum albumin was higher among patients with ΔBI ≥5 than among those without improvement (37.2 ± 4.7 vs 34.4 ± 5.3 g/L; P = 0.008). Albumin was associated with ΔBI ≥5 in the core model (adjusted odds ratio [aOR] per 1-g/L increase, 1.23; 95% confidence interval [CI], 1.08–1.41; P = 0.002) and after additional adjustment for age, sex, and hemoglobin (aOR, 1.19; 95% CI, 1.03–1.37; P = 0.015). Directionally consistent associations were observed for ΔBI ≥10 and continuous ΔBI. Conclusions Higher serum albumin at rehabilitation admission was associated with greater short-term functional improvement in basic ADL after cervical TSCI. Its consistent association across complementary outcome definitions supports further evaluation of albumin as an accessible component of multivariable prognostic assessment.