RESEARCHERS at Mohammed VI University Hospital in Oujda, Morocco have identified that serum albumin levels, specifically hypoalbuminemia, within the first 24 hours of hospital admission for acute pancreatitis (AP) could serve as a significant predictor of adverse outcomes and mortality. AP is a condition caused by the inflammation of the pancreas and while the majority of patients experience mild symptoms, some cases that lead to hospitalisation and intensive care. Hypoalbuminemia is a common manifestation in a variety of conditions, such as kidney failure, liver cirrhosis, and nephrotic syndrome. The study evaluated serum albumin levels in patients with AP to investigate the potential of albumin, as a prognostic biomarker in the early stages of acute pancreatitis.
Fakhrddine Amri, Mohammed VI University Hospital, and his colleagues conducted a retrospective study analysing data from 371 patients admitted with acute pancreatitis between 2018 and 2023. The average age of the cohort was 55.5 years, with women comprising 70.9% of the participants. The study focused on the relationship between serum albumin levels within 24 hours of admission and the subsequent outcomes of these patients. The average albumin level among the patients was 36.1 g/L, with 33.4% of the cases classified as hypoalbuminemic, defined as having albumin levels of 30 g/L or lower.
The results revealed that patients with hypoalbuminemia had a higher mean age and increased levels of creatinine and C-reactive protein, markers associated with inflammation and organ function. More critically, hypoalbuminemia was significantly linked to the development of persistent systemic inflammatory response syndrome (SIRS) after 48 hours, higher severity scores on the Bedside Index of Severity in Acute Pancreatitis (BISAP) and CT Severity Index, as well as the presence of pleural effusion and ascites.
In-hospital mortality among the cohort was 4.6%, with a striking 76.5% of these deaths occurring in patients with hypoalbuminemia. This association highlights the potential of serum albumin as an early indicator of severe complications and mortality risk in acute pancreatitis.
The study authors emphasised the need for further research to confirm these findings and explore the clinical benefits of incorporating serum albumin levels into routine decision-making processes for managing acute pancreatitis. If validated, this approach could lead to improved patient care and outcomes for AP.
Laith Gergi, EMJ
Reference
Amri F et al. Is serum albumin a pivotal biomarker in anticipating acute pancreatitis outcomes? BMC Gastroenterol. 2024;24(1):234.
