Low serum albumin levels prior to pediatric allogeneic HCT are associated with increased need for critical care interventions and increased 6-month mortality

Alicia M. Teagarden, Jodi L. Skiles, Andrew L. Beardsley, Michael J. Hobson, Elizabeth A.S. Moser, Jamie Renbarger, Courtney M. Rowan

Research output: Contribution to journalArticle

Abstract

Poor nutritional status in HCT patients is a negative prognostic factor. There are no pediatric studies evaluating albumin levels prior to HCT and need for critical care interventions. We hypothesized that pediatric patients with low albumin levels, routinely measured 30 days (±10 days) prior to allogeneic HCT, have a higher risk of critical care interventions in the post-transplant period. We performed a 5-year retrospective study of pediatric patients who underwent allogeneic HCT for any indication. Patients were categorized based on albumin level. Hypoalbuminemia was defined as <3.1 g/dL. A total of 73 patients were included, with a median age of 7.4 years (IQR 3.3, 13.2). Patients with hypoalbuminemia had higher needs for critical care interventions including non-invasive ventilation (44% vs 8%, P=.01), mechanical ventilation (67% vs 17%, P<.01), and vasoactive therapy (56% vs 16%, P=.01). Patients with hypoalbuminemia also had a higher 6-month mortality (56% vs 17%, P=.02). Our data demonstrate that children undergoing allogeneic HCT with hypoalbuminemia in the pretransplant period are more likely to require critical care interventions and have higher 6-month mortality. These findings identify an at-risk population in which nutritional improvements may be instituted prior to HCT in hopes of improving outcomes.

Original languageEnglish (US)
Article numbere13016
JournalPediatric Transplantation
Volume21
Issue number6
DOIs
StatePublished - Sep 1 2017

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Critical Care
Serum Albumin
Hypoalbuminemia
Pediatrics
Mortality
Albumins
Noninvasive Ventilation
Nutritional Status
Artificial Respiration
Retrospective Studies
Transplants

Keywords

  • critical care
  • nutritional status
  • pediatrics
  • stem cells
  • transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Low serum albumin levels prior to pediatric allogeneic HCT are associated with increased need for critical care interventions and increased 6-month mortality. / Teagarden, Alicia M.; Skiles, Jodi L.; Beardsley, Andrew L.; Hobson, Michael J.; Moser, Elizabeth A.S.; Renbarger, Jamie; Rowan, Courtney M.

In: Pediatric Transplantation, Vol. 21, No. 6, e13016, 01.09.2017.

Research output: Contribution to journalArticle

Teagarden, Alicia M. ; Skiles, Jodi L. ; Beardsley, Andrew L. ; Hobson, Michael J. ; Moser, Elizabeth A.S. ; Renbarger, Jamie ; Rowan, Courtney M. / Low serum albumin levels prior to pediatric allogeneic HCT are associated with increased need for critical care interventions and increased 6-month mortality. In: Pediatric Transplantation. 2017 ; Vol. 21, No. 6.
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