A recent study assessed the effect of albumin administration on mortality rates in patients with severe burns from the dataset of the Diagnosis Procedure Combination Database in Japan. Severe burns often lead to significant fluid loss which necessitates careful fluid resuscitation to maintain hemodynamic stability. Albumin is sometimes administered in these cases to help restore blood volume and improve patient outcomes.
The study spanned from April 2014 to March 2021 and focused on patients the aged 15 years and older who were admitted with severe burns which was defined by a burn index of 15 or more. The study categorized 2,492 eligible patients into two groups, one group who received albumin within the first two days of admission (albumin group, n = 1,128) and the other group who did not receive albumin (control group, n = 1,364). To ensure a more accurate comparison, the research employed a one-to-one propensity score matching method, which resulted in 530 matched pairs of patients from each group.
The primary outcome measured was the 28-day mortality rate where the study found no significant difference in mortality between the two groups. 21.7% of patients in the albumin group died within 28 days when compared to 22.8% in the control group. The risk difference was calculated to be -1.1%, with a 95% confidence interval ranging from -6.1% to +3.9% that indicated the variation in mortality rates between the two groups.
The findings suggest that the administration of albumin within two days of admission does not significantly impact mortality during the acute phase in patients with severe burns. This result challenges the notion that albumin administration is a critical factor in reducing short-term mortality in these patients. The outcomes of this study imply that further research, particularly randomized controlled trials, is necessary to confirm these findings and explore the potential benefits of albumin in other aspects of burn management.
Overall, while albumin administration is a common practice in the management of severe burns which may not be associated with improved survival during the acute phase. Therefore, Clinicians may need to reconsider the routine use of albumin in this context and focus on other aspects of burn care that might have a more significant impact on patient outcomes.
Reference:
Nakamura, K., Isogai, T., Ohbe, H., Nakajima, M., Matsui, H., Fushimi, K., & Yasunaga, H. (2024). Effect of fluid resuscitation with albumin on mortality in patients with severe burns: A nationwide inpatient data analysis. In Burns. Elsevier BV. https://doi.org/10.1016/j.burns.2024.07.031