Azza A. Moustafa et al JMSCR Volume 06 Issue 01 January 2018 Page 32299 JMSCR Vol||06||Issue||01||Page 32299-32306||January 2018 Evaluation of Hypoalbuminemia as a Predictor of Clinical Outcome in Critically Ill Children in Alexandria University Children's Hospital Authors Azza A. Moustafa 1 , Aminah S. Al Halawany 2 , Mohamed F. Rafa 3 Alexandria University Corresponding Author Mohamed F. Rafa Email: muhammad.rafa1985@gmail.com Abstract Outcome prediction is an important target in intensive care unit for providing information on patient outcomes for clinicians and family of critically ill patients. Hypoalbuminemia on admission is common in critical illness in all populations and proved to be a strong predictor of clinical outcome in adults. Because it is a simple, cheap and sensitive marker, it has been used for several purposes in adult Intensive Care Units (ICU) including outcome prediction. Although hypoalbuminemia is a common finding in critically ill children, there is a lack of data that evaluate its usefulness in predicting clinical outcome. In this retrospective study, we aimed to evaluate hypoalbuminemia as a predictor of clinical outcome in 487 critically ill children admitted to a tertiary hospital. Results showed that hypoalbuminemia was present at admission in 40.66% patients that increased to 53.8% during rest of the PICU stay. Hypoalbuminemia at admission was an independent predictor of mortality. Also, we found that patients with hypoalbuminemia at admission had a significantly higher Pediatric Logistic Organ Dysfunction score (PELOD), prolonged Pediatric Intensive Care Unit (PICU) stay and higher mortality. Patients with hypoalbuminemia during admission had significantly longer length of PICU stay, more need for mechanical ventilation, worse PELOD score, higher Pediatric Index of Mortality 2 (PIM2) score and higher mortality. Thus hypoalbuminemia at admission can be helpful for risk assessment and can be used as an outcome predictor in critically ill children. Keywords: hypoalbuminemia; serum albumin; clinical outcome; predictor; critically ill children; pediatric intensive care unit (PICU). Introduction Albumin is a water-soluble protein; it is distributed in the intravascular space and two- thirds in the extravascular space. It constitutes more than 50% of total plasma proteins, contributing about 80% of the plasma colloid osmotic pressure and is responsible for the transport and binding of many molecules. 1 This multifunctional protein is also an important extracellular non-enzymatic antioxidant, thereby protecting against oxidative stress-induced injury. 2 Abnormally low serum albumin levels are frequent and early biochemical derangements in critically ill adults with a reported incidence of 30–40%; the etiology of which is complex. 3 Normally, albumin has a long half-life (15–19 days), but the plasma albumin can rapidly fall by 10–15 g/l in 3 to 5 days in critically ill patients. 4 www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i1.139