Document Detail


Morbidity in hospitalized patients receiving human albumin: a meta-analysis of randomized, controlled trials.
MedLine Citation:
PMID:  15483411     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of albumin administration on morbidity in acutely ill hospitalized patients. DATA SOURCE: Computer searches of MEDLINE, EMBASE, and the Cochrane Library; hand searches of journals and Index Medicus; inquiries with investigators and fluid product suppliers; and examination of reference lists. No language or time period restrictions were adopted. STUDY SELECTION: Randomized, controlled trials comparing the administration of albumin with that of crystalloid, no albumin, or lower-dose albumin. DATA EXTRACTION: Two investigators independently extracted data. The primary endpoint for the meta-analysis was morbidity, defined as the incidence of complications, including death. Trial quality was evaluated by blinding, allocation concealment, presence of morbidity as a study endpoint, and individual patient crossover. DATA SYNTHESIS: Seventy-one trials were included in the categories of surgery or trauma, burns, hypoalbuminemia, high-risk neonates, ascites, and other indications. The 3,782 randomized patients in the included trials experienced a total of 3,287 complications, including 515 deaths and 2,772 cardiovascular, gastrointestinal, hepatic, infectious, renal, respiratory, and other complications. Albumin significantly reduced overall morbidity, with a risk ratio of 0.92 (confidence interval [CI], 0.86-0.98). Control group albumin dose significantly affected the incidence of complications (p = .002). In 32 trials with no albumin administered to the control group, the risk ratio was 0.77 (CI, 0.67-0.88) compared with 0.89 (CI, 0.80-1.00) in 20 trials with control patients receiving low-dose albumin and 1.07 (CI, 0.96-1.20) in 19 trials with moderate-dose control group albumin. CONCLUSIONS: Albumin reduces morbidity in acutely ill hospitalized patients. Concomitant administration of albumin in the control group can obscure the effects of albumin on clinical outcome in randomized trials.
Authors:
Jean-Louis Vincent; Roberta J Navickis; Mahlon M Wilkes
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  32     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-14     Completed Date:  2004-11-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2029-38     Citation Subset:  AIM; IM    
Affiliation:
Department of Intensive Care, Université Libre de Bruxelles, Hôpital Erasme, Brussels, Belgium. jlvincen@ulb.ac.be
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MeSH Terms
Descriptor/Qualifier:
Acute Disease / epidemiology*,  therapy*
Adolescent
Adult
Albumins / therapeutic use*
Child
Child, Preschool
Hospitalization
Humans
Infant
Middle Aged
Morbidity
Chemical
Reg. No./Substance:
0/Albumins
Comments/Corrections
Comment In:
Crit Care Med. 2005 May;33(5):1183; author reply 1183-5   [PMID:  15891381 ]
Crit Care Med. 2005 Apr;33(4):915; author reply 915-7   [PMID:  15818137 ]
Crit Care Med. 2005 Apr;33(4):914; author reply 915-7   [PMID:  15818135 ]
Crit Care Med. 2004 Oct;32(10):2154-5   [PMID:  15483432 ]
Crit Care Med. 2005 Mar;33(3):701-2   [PMID:  15753785 ]
Crit Care Med. 2005 Apr;33(4):914-5; author reply 915-7   [PMID:  15818134 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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