Hypoalbuminemia as a Predictor of Mortality in Patients with Septic Shock: A Retrospective Study

Background: Despite advances in treatment over the past 20 years that have significantly improved patient survival in shock conditions, septic shock continues to present numerous questions regarding long-term outcomes, primarily due to its associated metabolic changes.Objective: To evaluate hypoalbuminemia as a predictor of mortality in patients admitted with septic shock to the emergency department, through a review of clinical records from January to September 2023 at Hospital General Regional No. 1 (HGR1) in Michoacán, Mexico.Methods: A retrospective study analyzed patients diagnosed with septic shock between January and September 2023. The study examined admission albumin parameters and mortality, along with sociodemographic variables, comorbidities, mean arterial pressure, lactate levels, and vasopressor use.Results: The study included 130 patients meeting inclusion criteria, with equal gender distribution (50% male, n=65; 50% female, n=65). The predominant age group was over 68 years (35.3%, n=46), followed by 59-68 years (27.6%, n=36). Common comorbidities included systemic arterial hypertension (50.7%, n=66), diabetes mellitus (48.4%, n=63), chronic kidney disease (21.5%, n=28), and neoplasms (19.2%, n=25). Serum albumin levels were distributed as follows: ≥3.5 g/dL (13.8%, n=18), 3.4-3.0 g/dL (20%, n=26), 2.9-2.5 g/dL (24.6%, n=32), and <2.5 g/dL (41.5%, n=54). Among patients with albumin <2.5 g/dL, mortality was 92.5% (n=50), with only 7.4% (n=4) surviving to discharge. Statistical analysis using Pearson's Chi-square showed an asymptotic significance of 0.003 with a likelihood ratio of 0.346.Conclusions: This descriptive study demonstrates that hypoalbuminemia (<2.5 g/dL) is significantly associated with mortality in septic shock patients, with a mortality rate of 92.5%. The findings validate the initial hypothesis that hypoalbuminemia serves as a predictor of mortality in more than 50% of patients with septic shock.