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Background <p>The clinical impact of exogenous albumin supplementation in critically ill hypoalbuminemic patients with acute myocardial infarction (AMI) remains uncertain.</p> Methods <p>This retrospective cohort study utilized the MIMIC-IV (Medical Information Mart for Intensive Care-IV) database. Adult ICU patients with AMI and hypoalbuminemia were included. Albumin infusion during the ICU stay was considered clinician-driven supportive therapy rather than a protocol-directed intervention. Propensity score matching (PSM) was performed in a 1:1 ratio, yielding 153 patients in the albumin group and 153 matched controls. The primary outcomes were 30-day and 90-day all-cause mortality. Secondary outcomes included ICU and hospital length of stay. Multivariable regression analyzes were performed to adjust for potential confounders.</p> Results <p>The pre-matched cohort included 1,285 patients. After PSM, 306 patients (153 per group) with balanced baseline characteristics were included in the analysis. No significant differences were observed in 30-day mortality (34.0% vs. 35.9%, <i>p</i> = 0.719) or 90-day mortality (45.8% vs. 45.1%, <i>p</i> = 0.909). Cox regression showed no independent association between albumin infusion and 30-day mortality (HR 0.85; 95% CI 0.57–1.27; <i>p</i> = 0.429) or 90-day mortality (HR 0.97; 95% CI 0.68–1.37; <i>p</i> = 0.843). However, albumin infusion was associated with longer ICU stay (β = 4.34 days; 95% CI 2.91–5.76; <i>p</i> &lt; 0.001) and hospital stay (β = 4.43 days; 95% CI 1.12–7.74; <i>p</i> = 0.009).</p> Conclusion <p>In critically ill hypoalbuminemic patients with AMI, albumin infusion was not associated with reduced short-term mortality but was associated with longer ICU and hospital stays, likely reflecting greater illness severity rather than a causal treatment effect. Further prospective studies are warranted.</p>

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Assessing the clinical impact of albumin infusion in critically ill ICU patients with acute myocardial infarction and hypoalbuminemia: a retrospective propensity score-matched cohort study

  • 期刊论文

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  • 发表日期：

    2026年4月16日

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  • Ye Ding,
  • Kuiyue Wang,
  • Da Xu,
  • Xiaojin Xu,
  • Zhuyang Shen,
  • Xiaofei Huang,
  • Dan Huang

摘要

Background

The clinical impact of exogenous albumin supplementation in critically ill hypoalbuminemic patients with acute myocardial infarction (AMI) remains uncertain.

Methods

This retrospective cohort study utilized the MIMIC-IV (Medical Information Mart for Intensive Care-IV) database. Adult ICU patients with AMI and hypoalbuminemia were included. Albumin infusion during the ICU stay was considered clinician-driven supportive therapy rather than a protocol-directed intervention. Propensity score matching (PSM) was performed in a 1:1 ratio, yielding 153 patients in the albumin group and 153 matched controls. The primary outcomes were 30-day and 90-day all-cause mortality. Secondary outcomes included ICU and hospital length of stay. Multivariable regression analyzes were performed to adjust for potential confounders.

Results

The pre-matched cohort included 1,285 patients. After PSM, 306 patients (153 per group) with balanced baseline characteristics were included in the analysis. No significant differences were observed in 30-day mortality (34.0% vs. 35.9%, p = 0.719) or 90-day mortality (45.8% vs. 45.1%, p = 0.909). Cox regression showed no independent association between albumin infusion and 30-day mortality (HR 0.85; 95% CI 0.57–1.27; p = 0.429) or 90-day mortality (HR 0.97; 95% CI 0.68–1.37; p = 0.843). However, albumin infusion was associated with longer ICU stay (β = 4.34 days; 95% CI 2.91–5.76; p < 0.001) and hospital stay (β = 4.43 days; 95% CI 1.12–7.74; p = 0.009).

Conclusion

In critically ill hypoalbuminemic patients with AMI, albumin infusion was not associated with reduced short-term mortality but was associated with longer ICU and hospital stays, likely reflecting greater illness severity rather than a causal treatment effect. Further prospective studies are warranted.