Synergistic effect of hypoalbuminaemia and hypotension in predicting in-hospital mortality and intensive care admission: a retrospective cohort study.

Objective Hypoalbuminaemia is an important prognostic factor. It may be associated with poor nutritional states, chronic heart and kidney disease, long-standing infection and cancer. Hypotension is a hallmark of circulatory failure. We evaluated hypoalbuminaemia and hypotension synergism as predictor of in-hospital mortality and intensive care unit (ICU) admission. Design We retrospectively analysed emergency department (ED) visits from January 2011 to December 2019. Setting Data were retrieved from five Mount Sinai health system hospitals, New York. Participants We included consecutive ED patients ≥18 years with albumin measurements. Primary and secondary outcome measures Clinical outcomes were in-hospital mortality and ICU admission. The rates of these outcomes were stratified by systolic blood pressure (SBP) ( Results The cohort included 402 123 ED arrivals (27.9% of total adult ED visits). The rates of in-hospital mortality, ICU admission and overall admission were 1.7%, 8.4% and 47.1%, respectively. For SBP Conclusion Co-occurrence of hypotension and hypoalbuminaemia is associated with poor hospital outcomes.