Preterm morbiditeleri ve mortalitesinin tahmininde serum albümini ile laktat düzeyinin karşılaştırılması

Yıl 2023, Cilt: 48 Sayı: 1, 127 - 135, 31.03.2023

Aygül Elataş , Selvi Gülaşı , Mustafa Kurthan Mert , Eren Kale Çekinmez , Orkun Tolunay

https://doi.org/10.17826/cumj.1136151

Öz

Amaç: 32 haftadan küçük preterm bebeklerde neonatal morbiditeleri ve mortaliteyi öngörmede serum albumin ve laktat düzeylerini karşılaştırmayı amaçladık.
Gereç ve Yöntem: Bebeklerin tıbbi kayıtları retrospektif olarak incelendi. Hastalar üç gruba ayrıldı; plazma albümin düzeyi ≤ 2.5 g/dL olanlar Grup 1, 2.6-3 g/dL olanlar Grup 2 ve ≥ 3 g/dL olanlar Grup 3 olarak tanımlandı. < 28 gebelik haftası olan bebekler alt grup olarak analiz edildi.
Bulgular: Ortalama gebelik yaşı 28.7 ± 2.4 hafta ve ortalama doğum ağırlığı 1240 ± 405 gram olan 300 bebek dahil edildi. Mortaliteyi öngörmede; ilk üç gün içindeki albümin düzeyi duyarlılığı %74.4 ve özgüllüğü %73.2 (cut-off < 2.9 g/dL), en düşük albümin seviyesinin duyarlılığı %90.7 ve özgüllüğü %70.1 (cut-off < 2.65 g/dL), laktat seviyesinin duyarlılığı %67.4 ve özgüllüğü %63.3 (cut-off > 3.1 mmol/L) idi. < 28 hafta bebeklerin analizinde; en düşük albümin seviyesinin duyarlılığı %80 ve özgüllüğü %66.7 (cut-off < 2.45 g/dL), ilk üç gün içindeki albümin seviyesinin duyarlılığı %74.3 ve özgüllüğü %72.6 (cut-off < 2.8 g/dL), laktatın duyarlılığı %74.3 ve özgüllüğü %64.2 (cut-off > 3.1 mmol/L) idi.
Sonuç: Düşük serum albumin düzeyi mortaliteyi öngörmede laktata göre daha özgül ve duyarlı görünmektedir ve mortalite tahmin skorlarına eklenmesi düşünülebilir.

Anahtar Kelimeler

: Hipoalbüminemi, morbidite, mortalite, preterm, yenidoğan

Destekleyen Kurum

yok

Comparison of serum albumin level and lactate for predicting preterm morbidities and mortality

Öz

Purpose: We aimed to comparison of serum albumin and lactate level for predicting neonatal morbidities and mortality in preterm infants < 32 weeks of gestation.
Materials and Methods: The medical records of babies were retrospectively analyzed. Patients were divided into three groups; plasma albumin levels ≤ 2.5 g/dL were defined as Group 1, 2.6-3 g/dL as Group 2 and ≥ 3 g/dL as Group 3. The babies < 28 weeks of gestation were analysed as a subgroup.
Results: 300 infants with mean gestational age of 28.7 ± 2.4 weeks and mean birth weights 1240 ± 405 grams were included. In predicting mortality; the sensitivity of the albumin level within the first three days was 74.4% and the specificity was 73.2% (cut-off < 2.9 g/dL), the sensitivity of the lowest albumin level was 90.7% and the specificity was 70.1% (cut-off < 2.65 g/dL), the sensitivity of the lactate level was 67.4% and the specificity was 63.3% (cut off > 3.1 mmol/L). Analysis of < 28 weeks babies; the sensitivity of lowest albumin level was 80% and the specifity was 66.7% (cut-off < 2.45 g/dL) and the sensitivity of the albumin level within the first three days was 74.3% and the specificity was 72.6% (cut-off < 2.8 g/dL), and the sensitivity of lactate was 74.3% and the specifity was 64.2% (cut-off > 3.1mmol/L).
Conclusion: Low serum albumin level appears to be more specific and sensitive than lactate in predicting mortality and may be considered to be added to mortality prediction scores.

Anahtar Kelimeler

Hypoalbuminemia, morbidity, mortality, preterm, newborn

Kaynakça

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