The prognostic value of serum albumin level for long-term prognosis in patients with acute pulmonary embolism.

The aim of this study was to investigate the association of serum albumin (SA) level with long-term prognosis in patients with acute pulmonary embolism (PE).We retrospectively enrolled 269 patients with acute PE. SA level was obtained within 12-24 h following admission. The primary end points were incidence of short- and long-term mortality in acute PE patients. The mean duration of the study follow-up was 21±19 months.During the follow-up period, short and long-term mortality rates were higher in patients who had low SA level compared to those who did not have. In multivariate Cox regression analysis, SA level was found to be independently associated with long-term mortality (HR: 0.47, 95%CI: 0.28-0.78, p=0.004). In receiver operating characteristics analysis, SA level of ≤ 3.17 predicted long-term mortality with a sensitivity of 77.5% and a specificity of 79.5% (area under curve (AUC) 0.82, 95%CI: 0.76-0.87, p<0.001). In addition, when the SA plus simplified Pulmonary Embolism Severity Index (sPESI) risk score compared to sPESI risk score alone, it produced a net reclassification improvement of 0.22 with p<0.001, that is a 22% improved classification.To the best of our knowledge, this is the first study to demonstrate that low SA level is a strong and independent predictor for long-term mortality in patients with acute PE.