This investigation was prompted in part by several recent preclinical studies documenting a powerful neuroprotective effect associated with albumin in animal models of acute ischemic stroke.3,4
Below are reported outcomes in the albumin and saline comparison groups:
|
Albumin group
(n = 37) |
Saline only group
(n = 47) |
Statistic |
In-hospital deaths |
2 (5.4%)
|
9 (19%)
|
p = 0.07
|
Good outcome at 3 months (GOS > 4) |
68%
|
39%
|
OR = 3.2 (CI 1.1 – 11.0)
|
|
Hydrocephalus
|
10 (27%)
|
22 (47%)
|
p = 0.03
|
|
Six different proposed mechanisms of action for the neuroprotective effect of human albumin in patients
with SAH are cited by the authors, who believe that "the presence of a predominant mechanism is unlikely."
They also commented that "our data indicate that human albumin administration is not associated with increased healthcare expenditures in patients with SAH when total hospital cost is used as a surrogate measure."
While the investigators acknowledged that their study is retrospective and nonrandomized, and that it evaluates a fairly small sample, patients were sequentially admitted and the patient care protocol (outside of albumin administration) was unchanged over the two-year study period.
"Our preliminary data indicate that human albumin administration may be associated with a decreased incidence of symptomatic vasospasm and an increased proportion of good clinical outcomes after SAH,"
they concluded.
Citation: Suarez JI, Shannon L, Zaidat OO, et al. Effect of human albumin administration on clinical outcome and hospital cost in patients with subarachnoid hemorrhage. J Neurosurg 2004; 100:585-90.
