Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study
Identifieur interne : 000136 ( Ncbi/Merge ); précédent : 000135; suivant : 000137Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study
Auteurs : Jean-Louis Vincent [Belgique] ; Yasser Sakr [Belgique] ; Konrad Reinhart [Allemagne] ; Charles L. Sprung [Israël] ; Herwig Gerlach [Allemagne] ; V Marco Ranieri [Italie]Source :
- Critical Care [ 1364-8535 ] ; 2005.
Abstract
Albumin administration in the critically ill has been the subject of some controversy. We investigated the use of albumin solutions in European intensive care units (ICUs) and its relationship to outcome.
In a cohort, multicenter, observational study, all patients admitted to one of the participating ICUs between 1 May and 15 May 2002 were followed up until death, hospital discharge, or for 60 days. Patients were classified according to whether or not they received albumin at any time during their ICU stay.
Of 3,147 admitted patients, 354 (11.2%) received albumin and 2,793 (88.8%) did not. Patients who received albumin were more likely to have cancer or liver cirrhosis, to be surgical admissions, and to have sepsis. They had a longer length of ICU stay and a higher mortality rate, but were also more severely ill, as manifested by higher simplified acute physiology score (SAPS) II and sequential organ failure assessment (SOFA) scores than the other patients. A Cox proportional hazard model indicated that albumin administration was significantly associated with decreased 30-day survival. Moreover, in 339 pairs matched according to a propensity score, ICU and hospital mortality rates were higher in the patients who had received albumin than in those who had not (34.8 versus 20.9% and 41.3 versus 27.7%, respectively, both
Albumin administration was associated with decreased survival in this population of acutely ill patients. Further prospective randomized controlled trials are needed to examine the effects of albumin administration in sub-groups of acutely ill patients.
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DOI: 10.1186/cc3895
PubMed: 16356223
PubMed Central: 1414048
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Results of the SOAP study</title><author><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation></author><author><name sortKey="Sakr, Yasser" sort="Sakr, Yasser" uniqKey="Sakr Y" first="Yasser" last="Sakr">Yasser Sakr</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation></author><author><name sortKey="Reinhart, Konrad" sort="Reinhart, Konrad" uniqKey="Reinhart K" first="Konrad" last="Reinhart">Konrad Reinhart</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 101, 07747, Jena, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 101, 07747, Jena</wicri:regionArea><wicri:noRegion>07747, Jena</wicri:noRegion><wicri:noRegion>07747, Jena</wicri:noRegion><wicri:noRegion>Jena</wicri:noRegion></affiliation></author><author><name sortKey="Sprung, Charles L" sort="Sprung, Charles L" uniqKey="Sprung C" first="Charles L" last="Sprung">Charles L. Sprung</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Anaesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, P.O.B. 12000, 91120 Jerusalem, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Anaesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, P.O.B. 12000, 91120 Jerusalem</wicri:regionArea><wicri:noRegion>91120 Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Gerlach, Herwig" sort="Gerlach, Herwig" uniqKey="Gerlach H" first="Herwig" last="Gerlach">Herwig Gerlach</name><affiliation wicri:level="3"><nlm:aff id="I4">Department of Anaesthesiology and Intensive Care, Vivantes-Klinikum Neukölln, Rudower strasse 48, 12313 Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, Vivantes-Klinikum Neukölln, Rudower strasse 48, 12313 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Ranieri, V Marco" sort="Ranieri, V Marco" uniqKey="Ranieri V" first="V Marco" last="Ranieri">V Marco Ranieri</name><affiliation wicri:level="1"><nlm:aff id="I5">Department of Anaesthesiology and Intensive Care, S Giovanni Battista Hospital, University of Turin, Corso Dogliotti 14, 10126 Torino, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, S Giovanni Battista Hospital, University of Turin, Corso Dogliotti 14, 10126 Torino</wicri:regionArea><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">16356223</idno><idno type="pmc">1414048</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414048</idno><idno type="RBID">PMC:1414048</idno><idno type="doi">10.1186/cc3895</idno><date when="2005">2005</date><idno type="wicri:Area/Pmc/Corpus">000132</idno><idno type="wicri:Area/Pmc/Curation">000130</idno><idno type="wicri:Area/Pmc/Checkpoint">000138</idno><idno type="wicri:Area/Ncbi/Merge">000136</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study</title><author><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation></author><author><name sortKey="Sakr, Yasser" sort="Sakr, Yasser" uniqKey="Sakr Y" first="Yasser" last="Sakr">Yasser Sakr</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation></author><author><name sortKey="Reinhart, Konrad" sort="Reinhart, Konrad" uniqKey="Reinhart K" first="Konrad" last="Reinhart">Konrad Reinhart</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 101, 07747, Jena, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 101, 07747, Jena</wicri:regionArea><wicri:noRegion>07747, Jena</wicri:noRegion><wicri:noRegion>07747, Jena</wicri:noRegion><wicri:noRegion>Jena</wicri:noRegion></affiliation></author><author><name sortKey="Sprung, Charles L" sort="Sprung, Charles L" uniqKey="Sprung C" first="Charles L" last="Sprung">Charles L. Sprung</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Anaesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, P.O.B. 12000, 91120 Jerusalem, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Anaesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, P.O.B. 12000, 91120 Jerusalem</wicri:regionArea><wicri:noRegion>91120 Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Gerlach, Herwig" sort="Gerlach, Herwig" uniqKey="Gerlach H" first="Herwig" last="Gerlach">Herwig Gerlach</name><affiliation wicri:level="3"><nlm:aff id="I4">Department of Anaesthesiology and Intensive Care, Vivantes-Klinikum Neukölln, Rudower strasse 48, 12313 Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, Vivantes-Klinikum Neukölln, Rudower strasse 48, 12313 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Ranieri, V Marco" sort="Ranieri, V Marco" uniqKey="Ranieri V" first="V Marco" last="Ranieri">V Marco Ranieri</name><affiliation wicri:level="1"><nlm:aff id="I5">Department of Anaesthesiology and Intensive Care, S Giovanni Battista Hospital, University of Turin, Corso Dogliotti 14, 10126 Torino, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, S Giovanni Battista Hospital, University of Turin, Corso Dogliotti 14, 10126 Torino</wicri:regionArea><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author></analytic><series><title level="j">Critical Care</title><idno type="ISSN">1364-8535</idno><idno type="eISSN">1466-609X</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Albumin administration in the critically ill has been the subject of some controversy. We investigated the use of albumin solutions in European intensive care units (ICUs) and its relationship to outcome.</p></sec><sec sec-type="methods"><title>Methods</title><p>In a cohort, multicenter, observational study, all patients admitted to one of the participating ICUs between 1 May and 15 May 2002 were followed up until death, hospital discharge, or for 60 days. Patients were classified according to whether or not they received albumin at any time during their ICU stay.</p></sec><sec><title>Results</title><p>Of 3,147 admitted patients, 354 (11.2%) received albumin and 2,793 (88.8%) did not. Patients who received albumin were more likely to have cancer or liver cirrhosis, to be surgical admissions, and to have sepsis. They had a longer length of ICU stay and a higher mortality rate, but were also more severely ill, as manifested by higher simplified acute physiology score (SAPS) II and sequential organ failure assessment (SOFA) scores than the other patients. A Cox proportional hazard model indicated that albumin administration was significantly associated with decreased 30-day survival. Moreover, in 339 pairs matched according to a propensity score, ICU and hospital mortality rates were higher in the patients who had received albumin than in those who had not (34.8 versus 20.9% and 41.3 versus 27.7%, respectively, both <italic>p</italic> < 0.001).</p></sec><sec><title>Conclusion</title><p>Albumin administration was associated with decreased survival in this population of acutely ill patients. Further prospective randomized controlled trials are needed to examine the effects of albumin administration in sub-groups of acutely ill patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Crit Care</journal-id><journal-title>Critical Care</journal-title><issn pub-type="ppub">1364-8535</issn><issn pub-type="epub">1466-609X</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">16356223</article-id><article-id pub-id-type="pmc">1414048</article-id><article-id pub-id-type="publisher-id">cc3895</article-id><article-id pub-id-type="doi">10.1186/cc3895</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study</article-title></title-group><contrib-group><contrib id="A1" corresp="yes" contrib-type="author"><name><surname>Vincent</surname><given-names>Jean-Louis</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>jlvincen@ulb.ac.be</email></contrib><contrib id="A2" contrib-type="author"><name><surname>Sakr</surname><given-names>Yasser</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>Yasser.Sakr@med.uni-jena.de</email></contrib><contrib id="A3" contrib-type="author"><name><surname>Reinhart</surname><given-names>Konrad</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>Konrad.Reinhart@med.uni-jena.de</email></contrib><contrib id="A4" contrib-type="author"><name><surname>Sprung</surname><given-names>Charles L</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>sprung@cc.huji.ac.il</email></contrib><contrib id="A5" contrib-type="author"><name><surname>Gerlach</surname><given-names>Herwig</given-names></name><xref ref-type="aff" rid="I4">4</xref><email>herwig.gerlach@vivantes.de</email></contrib><contrib id="A6" contrib-type="author"><name><surname>Ranieri</surname><given-names>V Marco</given-names></name><xref ref-type="aff" rid="I5">5</xref><email>marco.ranieri@unito.it</email></contrib><contrib id="A7" contrib-type="author"><on-behalf-of>the 'Sepsis Occurrence in Acutely Ill Patients' investigators</on-behalf-of></contrib></contrib-group><aff id="I1"><label>1</label>Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium</aff><aff id="I2"><label>2</label>Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 101, 07747, Jena, Germany</aff><aff id="I3"><label>3</label>Department of Anaesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, P.O.B. 12000, 91120 Jerusalem, Israel</aff><aff id="I4"><label>4</label>Department of Anaesthesiology and Intensive Care, Vivantes-Klinikum Neukölln, Rudower strasse 48, 12313 Berlin, Germany</aff><aff id="I5"><label>5</label>Department of Anaesthesiology and Intensive Care, S Giovanni Battista Hospital, University of Turin, Corso Dogliotti 14, 10126 Torino, Italy</aff><pub-date pub-type="ppub"><year>2005</year></pub-date><pub-date pub-type="epub"><day>7</day><month>11</month><year>2005</year></pub-date><volume>9</volume><issue>6</issue><fpage>R745</fpage><lpage>R754</lpage><ext-link ext-link-type="uri" xlink:href="http://ccforum.com/content/9/6/R745"></ext-link><history><date date-type="received"><day>9</day><month>5</month><year>2005</year></date><date date-type="rev-request"><day>24</day><month>6</month><year>2005</year></date><date date-type="rev-recd"><day>13</day><month>9</month><year>2005</year></date><date date-type="accepted"><day>7</day><month>10</month><year>2005</year></date></history><copyright-statement>Copyright © 2005 Vincent et al.; licensee BioMed Central Ltd.</copyright-statement><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><p>This is an open access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0"></ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p></license><abstract><sec><title>Introduction</title><p>Albumin administration in the critically ill has been the subject of some controversy. We investigated the use of albumin solutions in European intensive care units (ICUs) and its relationship to outcome.</p></sec><sec sec-type="methods"><title>Methods</title><p>In a cohort, multicenter, observational study, all patients admitted to one of the participating ICUs between 1 May and 15 May 2002 were followed up until death, hospital discharge, or for 60 days. Patients were classified according to whether or not they received albumin at any time during their ICU stay.</p></sec><sec><title>Results</title><p>Of 3,147 admitted patients, 354 (11.2%) received albumin and 2,793 (88.8%) did not. Patients who received albumin were more likely to have cancer or liver cirrhosis, to be surgical admissions, and to have sepsis. They had a longer length of ICU stay and a higher mortality rate, but were also more severely ill, as manifested by higher simplified acute physiology score (SAPS) II and sequential organ failure assessment (SOFA) scores than the other patients. A Cox proportional hazard model indicated that albumin administration was significantly associated with decreased 30-day survival. Moreover, in 339 pairs matched according to a propensity score, ICU and hospital mortality rates were higher in the patients who had received albumin than in those who had not (34.8 versus 20.9% and 41.3 versus 27.7%, respectively, both <italic>p</italic> < 0.001).</p></sec><sec><title>Conclusion</title><p>Albumin administration was associated with decreased survival in this population of acutely ill patients. Further prospective randomized controlled trials are needed to examine the effects of albumin administration in sub-groups of acutely ill patients.</p></sec></abstract></article-meta><notes><p>See related commentary <ext-link ext-link-type="uri" xlink:href="http://ccforum.com/content/9/6/649"></ext-link></p></notes></front></pmc><affiliations><list><country><li>Allemagne</li><li>Belgique</li><li>Israël</li><li>Italie</li></country><region><li>Berlin</li><li>Piémont</li><li>Vienne (Autriche)</li></region><settlement><li>Berlin</li><li>Turin</li><li>Vienne (Autriche)</li></settlement></list><tree><country name="Belgique"><region name="Vienne (Autriche)"><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name></region><name sortKey="Sakr, Yasser" sort="Sakr, Yasser" uniqKey="Sakr Y" first="Yasser" last="Sakr">Yasser Sakr</name></country><country name="Allemagne"><noRegion><name sortKey="Reinhart, Konrad" sort="Reinhart, Konrad" uniqKey="Reinhart K" first="Konrad" last="Reinhart">Konrad Reinhart</name></noRegion><name sortKey="Gerlach, Herwig" sort="Gerlach, Herwig" uniqKey="Gerlach H" first="Herwig" last="Gerlach">Herwig Gerlach</name></country><country name="Israël"><noRegion><name sortKey="Sprung, Charles L" sort="Sprung, Charles L" uniqKey="Sprung C" first="Charles L" last="Sprung">Charles L. Sprung</name></noRegion></country><country name="Italie"><region name="Piémont"><name sortKey="Ranieri, V Marco" sort="Ranieri, V Marco" uniqKey="Ranieri V" first="V Marco" last="Ranieri">V Marco Ranieri</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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