Frequency of Hypoalbuminemia and 30-Day In-Hospital Mortality in Critically Ill Patients Admitted at Intensive Care Unit of a Tertiary Care Hospital, Karachi

Abstract

Hypoalbuminemia often develops in critically ill patients and has been linked with higher mortality. Data from South Asia remains scarce. We examined the frequency of hypoalbuminemia and its association with 30-day in-hospital mortality among patients admitted to a tertiary care ICU in Karachi, Pakistan. Methods: We prospectively enrolled 162 adults admitted to the ICU. We collected demographic and clinical information and measured serum albumin within 24 hours of admission from November 2024 till April 2025. We defined hypoalbuminemia as albumin <3.5 g/dL. We calculated the frequency of hypoalbuminemia and 30-day in-hospital mortality and compared outcomes between patients with and without hypoalbuminemia. Results: Of 162 patients, 110 (67.9%) were aged 56–80 years, and 87 (53.7%) were female. Hypertension (46.9%) and type II diabetes (23.5%) were the most common comorbidities. Sixty-four patients (39.5%) had hypoalbuminemia, and 33 (20.4%) died within 30 days. Patients with diabetes were more likely to have hypoalbuminemia than those without diabetes (57.9% vs. 33.9%, p=0.01). Hypoalbuminemia was significantly associated with higher 30-day mortality (p=0.01). Conclusion: We found that hypoalbuminemia was common in critically ill patients and that it predicted 30-day in-hospital mortality. Measuring serum albumin at ICU admission may provide a practical and straightforward way to identify patients at increased risk of poor outcomes. Future studies should assess whether monitoring albumin trends or addressing hypoalbuminemia in treatment strategies can improve survival.