Hypoalbuminemia as a Predictor of 30-day Mortality in Patients with Acute Organophosphate Insecticide Poisoning

ABSTRACT

PURPOSE: The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied. METHODS: This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis. RESULTS: A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was 57.3±17.0 years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ≥3.5 g/dl) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690–0.881) and the APACHE II score was 0.840 (95% CI, 0.770–0.910). CONCLUSION: Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.