Zulkifli Amin1, Riahdo J. Saragih2
1Respirology and Critical Care Division, Internal Medicine Department FKUI/RSCM 2Internal Medicine Department FKUI/RSCM

ABSTRACT
Background: Ventilator-associated pneumonia (VAP) is considered as the most common nosocomial infection in the intensive care unit (ICU) with high mortality rates. Hypoalbuminemia has been recognized as poor prognostic indicator in critically ill patients but its role in patients with VAP is not fully known. The aim of this study was to evaluate the role of initial serum albumin in predicting the mortality of patient with VAP. Method: We designed a retrospective study to analyze data from hospitalized patients with VAP between 2003 - 2012 in Cipto Mangunkusumo Hospital, a tertiary hospital in Indonesia. Patients were grouped based on their initial serum albumin levels into: Group-1 (less than 2.7 g/dL), Group-2 (2.7 to 3.5 g/dL), and Group-3 (above 3.5 g/dL). We analyzed the hazard of in-hospital-mortality with cox proportional hazard model.
Results: Out of 194 patients evaluated in this study, 95 patients (49%) were included in Group-1, 83 patients (42.8%) in Group-2, and 16 patients (8.2%) in Group-3. Overall mortality rate was 58.2%. The hazards of in-hospital- mortality in Group-1 and Group-2 were 2.48 (95% CI 1.07 to 5.74; p = 0.033) and 1.42 (95% CI 0.60 to 3.34; p = 0.43), respectively, compared to Group-3.
Conclusion: Hypoalbuminemia increases the risk of mortality and initial serum albumin level should be considered as a predictor of mortality in every patient with VAP.
Key words: Serum albumin, predictor, mortality, VAP