Serum Albumin Level at Intensive Care Unit Admission and Delirium Duration and Severity in Critically Ill Adults.
Rosalyn Chi, Anthony J Perkins, Yara Khalifeh and 7 others
PMID 39482092WHAT IT FOUND
Low albumin at ICU admission did not predict how long delirium lasted or how severe it was in adults with delirium.
However, patients with low albumin stayed in the hospital and ICU longer and were less likely to be discharged alive.
Key findings
01Serum albumin level was not associated with delirium duration or severity after adjusting for clinical and demographic characteristics.
02Higher albumin levels were associated with shorter ICU and hospital stays, while hypoalbuminemia was associated with a lower probability of discharge alive.
03Sepsis diagnosis and lower baseline instrumental activities of daily living were associated with worse delirium outcomes, suggesting these factors are more predictive than albumin.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
This was a secondary analysis of data from a different trial, so albumin was not collected for all patients, and the sample was skewed toward lower albumin levels. The group with normal albumin levels was very small (13 patients), which may have reduced the statistical power to detect differences. The study did not account for subsyndromal delirium (mild symptoms that do not meet full diagnostic criteria), which might have masked a relationship between albumin and subtle cognitive changes. Delirium severity was calculated as an average over time, which may not reflect the intensity of acute episodes. The findings apply only to ICU patients and may not generalize to ward patients who are more likely to have normal albumin levels.
Declared interests
The original PMD study was funded by the National Institute of Nursing Research. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the lack of association with delirium severity as evidence that albumin is irrelevant to patient care. Low albumin significantly predicted longer hospital and ICU stays and lower likelihood of discharge alive, indicating it is a strong marker for overall prognosis and resource use, even if it does not drive delirium symptoms directly.