Article

Serum albumin concentration and waiting list mortality in idiopathic interstitial pneumonia.

Interstitial Lung Disease Center, David Geffen School of Medicine at UCLA, 37-131 Center for Health Sciences, Los Angeles, CA 90095, USA.
Chest (impact factor: 5.25). 11/2008; 135(4):929-35. DOI:10.1378/chest.08-0754
Source: PubMed

ABSTRACT Hypoalbuminemia is a reliable predictor of mortality in patients with various illnesses as well as a predictor of disability and mortality in healthy older adults. The association between hypoalbuminemia and mortality in patients with idiopathic interstitial pneumonia remains unknown. The objective of this study was to examine the relationship between serum albumin concentration and mortality in a large cohort of patients with idiopathic interstitial pneumonia listed for lung transplantation.
In patients classified as having idiopathic pulmonary fibrosis who were listed for lung transplantation with the United Network for Organ Sharing between January 1, 2004, and December 31, 2006 (n = 1,269), we studied the relationship between serum albumin concentration at the time of listing and mortality while awaiting transplantation.
Lower serum albumin was associated with increased mortality rate. Patients with lower categories of serum albumin had increased mortality rates before and after multivariable adjustment (p value for linear trend < 0.0001). Analysis with serum albumin as a continuous predictor indicated that the mortality rate increased by 54% with each 0.5 g/dL decrease in serum albumin concentration (95% confidence interval, 32 to 79%).
Lower serum albumin is strongly and independently associated with higher mortality in patients with idiopathic interstitial pneumonia on transplant waiting lists.

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Keywords

95% confidence interval
 
continuous predictor
 
December 31
 
healthy older adults
 
higher mortality
 
idiopathic interstitial pneumonia
 
idiopathic pulmonary fibrosis
 
January 1
 
large cohort
 
lower categories
 
Lower serum albumin
 
lung transplantation
 
mortality rate
 
mortality rates
 
multivariable adjustment
 
Organ Sharing
 
reliable predictor
 
serum albumin
 
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various illnesses