Serum albumin level and nosocomial pneumonia in stroke patients
Department of Neurology, Jagiellonian University, Krakow, Poland. European Journal of Neurology
(Impact Factor: 4.06).
04/2006; 13(3):299-301. DOI: 10.1111/j.1468-1331.2006.01210.x
Hypoalbuminemia is associated with increased risk of infections. The aim of this study was to determine if serum albumin level is an independent predictor of nosocomial pneumonia in stroke patients. Data of 705 consecutive ischemic stroke patients admitted within 24 h after stroke onset were analyzed retrospectively. Serum albumin level was measured within 36 h after stroke onset. Nosocomial pneumonia was found in 10.5% of stroke patients. Patients with pneumonia had significantly lower serum albumin level than those without pneumonia (31.9 +/- 7.5 g/l vs. 35.5 +/- 6.9 g/l) and serum albumin level was associated with risk of pneumonia on multivariate analysis (OR: 0.95, 95% CI: 0.91-0.98). Our results show that serum albumin level is an independent predictor of nosocomial pneumonia in stroke patients.
Available from: Diederik van de Beek
- "Studies including a small subgroup of patients, i.e., those restricted to patients with dysphagia, were excluded to minimize selection bias. If two publications described one similar patient group data was used only once; this occurred three times [4-9]. If studies reported data of different treatment arms separately, these were also included as separate groups in our analysis [10,11]. "
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ABSTRACT: stroke is the main cause of disability in high-income countries, and ranks second as a cause of death worldwide. Patients with acute stroke are at risk for infections, but reported post-stroke infection rates vary considerably. We performed a systematic review and meta-analysis to estimate the pooled post-stroke infection rate and its effect on outcome.
MEDLINE and EMBASE were searched for studies on post-stroke infection. Cohort studies and randomized clinical trials were included when post-stroke infection rate was reported. Rates of infection were pooled after assessment of heterogeneity. Associations between population- and study characteristics and infection rates were quantified. Finally, we reviewed the association between infection and outcome.
87 studies were included involving 137817 patients. 8 studies were restricted to patients admitted on the intensive care unit (ICU). There was significant heterogeneity between studies (P < 0.001, I(2) = 97%). The overall pooled infection rate was 30% (24-36%); rates of pneumonia and urinary tract infection were 10% (95% confidence interval [CI] 9-10%) and 10% (95%CI 9-12%). For ICU studies, these rates were substantially higher with 45% (95% CI 38-52%), 28% (95%CI 18-38%) and 20% (95%CI 0-40%). Rates of pneumonia were higher in studies that specifically evaluated infections and in consecutive studies. Studies including older patients or more females reported higher rates of urinary tract infection. Pneumonia was significantly associated with death (odds ratio 3.62 (95%CI 2.80-4.68).
Infection complicated acute stroke in 30% of patients. Rates of pneumonia and urinary tract infection after stroke were 10%. Pneumonia was associated with death. Our study stresses the need to prevent infections in patients with stroke.
Available from: academicjournals.org
- "It combines many types of substances and maintains colloid osmotic pressure (Kass and Lipton, 1989). Albumin not only has neuroprotective effects against stroke (Parkkinen et al., 2007; Koch et al., 2004), but is also a new biological marker of ischemia (Abboud et al., 2007; Dziedzic et al., 2006). Therefore, we hypothesized that albumin could help adult neocortical neurons to live in vitro. "
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ABSTRACT: Primary embryonic or young neuronal cells are used to study physiology or pathology of neurons. However, they are not optimal as a model for age-related changes in physiology or late-onset disease. Successful culturing of neurons from adult animals, however, has been historically difficult. Because the attack of anoxia and mechanical/chemical force in the course of the single neuron separated from the brain, the adult neocortex neurons may be edema. Since albumin can reduce edema and absorb toxic, we therefore hypothesized that albumin should improve the neuron survival in vitro. Here, we report that 0.2-0.5% albumin can accelerate neurons adherence to dish bottom, increase the attached cells number, and improve the viability. Our results indicate that fraction V of albumin is an effective supplier for neocortex neurons culture in vitro.
Available from: nature.com
- "Hypoalbuminemia was reported in up to 19% of stroke patients (Davalos et al., 1996; Gariballa et al., 1998; Davis et al., 2004). Stroke patients with hypoalbuminemia at admission had increased risk of infective complications (Gariballa et al., 1998; Dziedzic et al., 2006), death (Gariballa et al., 1998; Davis et al., 2004) and poor functional outcome (Davalos et al., 1996; Gariballa et al., 1998). "
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ABSTRACT: Hypoalbuminemia in acute stroke patients is associated with increased mortality and morbidity. The aim of our study was to determine the frequency and correlates of hypoalbuminemia in unselected cohort of patients with acute cerebral infarction.
Seven hundred and five consecutive ischemic stroke patients.
Albumin and other serum protein fractions were measured within 36 h after stroke using electrophoresis.
Hypoalbuminemia defined as serum albumin level <35 g/l was found in 45.5% of patients. Serum albumin level correlates significantly with age (r=-0.13, P<0.01), Scandinavian Stroke Scale score (r=0.14, P<0.01), body temperature on admission (r=0.14, P<0.01), leukocyte count (r=-0.17, P<0.01), fasting glucose (r=-0.16, P<0.01), total cholesterol (r=0.14, P<0.01), alpha1-globulin (r=-0.48, P<0.01), alpha2-globulin (r=-0.49, P<0.01), beta-globulin (r=-0.26, P<0.01) and gamma-globulin (r=-0.35, P<0.01).
Hypoalbuminemia is a frequent finding in acute stroke patients and it is associated with more severe stroke and pro-inflammatory pattern of serum protein electrophoresis.
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