Diagnostic performance of initial serum albumin level for predicting in-hospital mortality among aspiration pneumonia patients

Purpose The predictive value of serum albumin in adult aspiration pneumonia patients remains unknown. Methods Using data collected during a 3-year retrospective cohort of hospitalized adult patients with aspiration pneumonia, we evaluated the predictive value of serum albumin level at ED presentation for in-hospital mortality. Results 248 Patients were enrolled; of these, 51 cases died (20.6%). The mean serum albumin level was 3.4 ± 0.7 g/dL and serum albumin levels were significantly lower in the non-survivor group than in the survivor group (3.0 ± 0.6 g/dL vs. 3.5 ± 0.6 g/dL). In the multivariable logistic regression model, albumin was associated with in-hospital mortality significantly (adjusted odds ratio 0.30, 95% confidential interval (CI) 0.16–0.57). The area under the receiver operating characteristics (AUROC) for in-hospital survival was 0.72 (95% CI 0.64–0.80). The Youden index was 3.2 g/dL and corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive and negative likelihood ratio were 68.6%, 66.5%, 34.7%, 89.1%, 2.05 and 0.47, respectively. High sensitivity (98.0%) was shown at albumin level of 4.0 g/dL and high specificity (94.9%) was shown at level of 2.5 g/dL. Conclusion Initial serum albumin levels were independently associated with in-hospital mortality among adult patients hospitalized with aspiration pneumonia and demonstrated fair discriminative performance in the prediction of in-hospital mortality.