Cardiothoracic & vascular anesthesia
Perioperative Albumin Among Adults Undergoing Thoracic Surgery in the United States: Utilization, Associations With Clinical Outcomes, and Contribution to Hospital Costs
Authors' conclusion
Albumin use varies widely across hospitals, and 9% of patients receive it (median 500 mL). Use was not associated with in-hospital mortality and was associated with more morbidity and cost. The cost of albumin accounted for a trivial portion of hospital costs.
Study context
- Population
- Adults undergoing open and minimally invasive thoracic surgery, US hospitals, 2011–201714,672 open
- Exposure
- Albumin on the day of surgery vs no albumin
- Outcome
- Albumin use
Methodological detailsnationwide sample of US hospitals, standardized mortality ratio propensity score weighted analysis
- Nationwide sample of US hospitals
- Standardized mortality ratio propensity score weighted analysis
Main finding
As reported in the abstract
Hospitals using albumin
170 of 342
Patients receiving albumin, open surgery (n = 14,672)
13%
Patients receiving albumin, minimally invasive surgery (n = 22,532)
7%
Median albumin volume
500 mL
Observational data: associations, not effects.
Further findings
| Outcome | Difference ($) (CI) |
|---|---|
| Total hospital costsRecipients vs Nonrecipients · open surgery | 4,744 ($3,591, $5,897) |
| Total hospital costsRecipients vs Nonrecipients · minimally invasive surgery | 5,088 ($4,075, $6,100) |
- Total hospital costs — Albumin accounted for 2.6% of this difference (median per patient)
- $124 [$83-$189]
In-hospital mortality, open surgery
- Albumin use not associated with in-hospital mortality
- 1.17 [0.72, 1.92] (adjusted RR [CI])
- Standardized mortality ratio propensity score weighted analysis
In-hospital mortality, minimally invasive surgery
- Albumin use not associated with in-hospital mortality
- 1.51 [0.97, 2.34] (adjusted RR [CI])
- Standardized mortality ratio propensity score weighted analysis
Safety
- Albumin use associated with morbidity, more so with minimally invasive procedures than open surgery
Original publication
Perioperative Albumin Among Adults Undergoing Thoracic Surgery in the United States: Utilization, Associations With Clinical Outcomes, and Contribution to Hospital Costs. J Cardiothorac Vasc Anesth. Published 3 July 2024. doi:10.
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