USO DE ALBUMINA E RISCO DE MORTALIDADE

Sao Paulo Med J. 2010;128(5):289-95.

Use of albumin as a risk factor for hospital mortality among burn patients in
Brazil: non-concurrent cohort study.

Caleman G, Morais JF, Puga ME, Riera R, Atallah AN.

Faculdade de Medicina de Marília, Marília, São Paulo, Brazil.

CONTEXT AND OBJECTIVE: among burn patients, it is common to use colloidal
substances under the justification that it is necessary to correct the oncotic
pressure of the plasma, thereby reducing the edema in the burnt area and the
hypotension. The aim here was to assess the risk of hospital mortality, comparing
the use of albumin and crystalloid solutions for these patients.
DESIGN AND SETTING: non-concurrent historical cohort study at Faculdade de
Medicina de Marília; within the Postgraduate program on Internal and Therapeutic
Medicine, Universidade Federal de São Paulo; and at the Brazilian Cochrane
Center.
METHODS: burn patients hospitalized between 2000 and 2001, with registration in
the Hospital Information System, who received albumin, were compared with those
who received other types of volume replacement. The primary outcome was the
hospital mortality rate. The data were collected from files within the Datasus
software.
RESULTS: 39,684 patients were included: 24,116 patients with moderate burns and
15,566 patients with major burns. Among the men treated with albumin, the odds
ratio for the risk of death was 20.58 (95% confidence interval, CI: 11.28-37.54)
for moderate burns and 6.24 (CI 5.22-7.45) for major burns. Among the women, this
risk was 40.97 for moderate burns (CI 21.71-77.30) and 7.35 for major burns (CI
5.99-9.01). The strength of the association between the use of albumin and the
risk of death was maintained for the other characteristics studied, with
statistical significance.
CONCLUSION: the use of albumin among patients with moderate and major burns was
associated with considerably increased mortality.