Serum Albumin Level at Intensive Care Unit Admission and Delirium Duration and Severity in Critically Ill Adults

Am J Crit Care. 2024 Nov 1;33(6):412-420. doi: 10.4037/ajcc2024650.

Abstract

Background: Hypoalbuminemia has been associated with an increased risk of in-hospital delirium. However, the relationship between serum albumin levels and the duration and severity of delirium is not well defined.

Objective: To investigate the relationship between albumin levels and delirium duration and severity.

Methods: Study data were from a randomized controlled trial involving adult intensive care unit patients (≥ 18 years old) admitted to 3 academic hospitals from 2009 to 2015 who had positive delirium screening results on the Confusion Assessment Method for the Intensive Care Unit-7. Delirium severity was defined by mean Confusion Assessment Method for the Intensive Care Unit-7 scores by day 8. Delirum duration was defined by the number of delirium-free and coma-free days by day 8. Serum albumin levels within 72 hours of intensive care unit admission were collected from electronic medical records.

Results: The study included 237 patients (mean age, 60.3 years; female sex, 52.7%; receiving mechanical ventilation, 59.5%; acute respiratory failure or sepsis, 57.8%). Serum albumin levels were categorized as 3 g/dL or greater (n = 13), 2.5 to 2.99 g/dL (n = 142), and less than 2.5 g/dL (n = 82). After adjustment for demographic and clinical characteristics, no significant associations between albumin levels and delirium duration or severity were found. However, patients with normal albumin levels (≥3 g/dL) had shorter stays than did patients with hypoalbuminemia.

Conclusion: In patients with delirium, higher albumin levels were associated with shorter hospital stays but not with delirium duration or severity.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Critical Illness*
  • Delirium* / blood
  • Delirium* / diagnosis
  • Delirium* / epidemiology
  • Female
  • Humans
  • Hypoalbuminemia / epidemiology
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Serum Albumin* / analysis
  • Severity of Illness Index*
  • Time Factors

Substances

  • Serum Albumin