Effect of serum albumin level on hospital outcomes in out-of-hospital cardiac arrest

Background: Background: Serum albumin has been known as a strong predictive value of mortality in various disease conditions, severe burns, major surgeries, stroke, myocardial infarction, etc. But little is known for the effect of serum albumin level on out-of-hospital cardiac arrest patients. Objectives: This study aimed to investigate the effect of serum albumin level on the outcome of out of hospital cardiac arrest. Methods: This study was a prospective hospital-based patient cohort study, conducted during January to December 2014 at 27 emergency departments in Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance project. The albumin was measured immediately after arrival to the emergency department during cardiopulmonary resuscitation, and albumin was categorized into two groups, group < 3.5 g/dL group and ⩾ 3.5 g/dL group. The primary outcome was a good neurological recovery at discharge (cerebral performance category scale 1 or 2). Multivariable logistic regression was used for adjusting for confounders. Results: During the study period, 1616 out-of-hospital cardiac arrest patients with presumed cardiac etiology were enrolled, and the total of 1013 patients were analyzed in this study. A total 452 (44.6%) patients had serum albumin level less than 3.5 g/dL. The serum albumin ⩾ 3.5 g/dL group showed better neurological outcomes than the serum albumin < 3.5 g/dL group: 18.5% versus 4.0%, and ⩾ 3.5 g/dL group had higher survival discharge rates than the < 3.5 g/dL group: 23.9% versus 9.1% (p < 0.01). After adjusting for potential covariates, patients with serum albumin ⩾ 3.5 g/dL had a higher odds of good neurological recovery (adjusted odds ratio: 2.94 (95% confidence interval: [1.57, 5.49])), and higher survival to discharge (adjusted odds ratio: 1.74 (95% confidence interval: [1.10, 2.76])). Conclusion: Low serum albumin levels are associated with a worse neurologic outcome in patients with out-of-hospital cardiac arrest.