Objective: The prognostic utility of serum albumin level for mortality in heart failure patients has received considerable attention. This meta-analysis sought to examine the prognostic significance of hypoalbuminemia for prediction of all-cause mortality in patients with heart failure. Materials and methods: Pubmed and Embase databases were systematically searched up to 10 March 2019 to identify eligible studies. Epidemiological studies reporting a multivariable-adjusted risk estimate of all-cause mortality associated with hypoalbuminemia in acute or chronic heart failure patients were included. Results: Nine studies from 10 articles involving 16,763 heart failure patients were included in the final analysis. Hypoalbuminemia was associated with an increased in-hospital mortality (risk ratio [RR] 4.90; 95% confidence interval [CI] 2.96-8.10) and long-term all-cause mortality (RR 1.75; 95% CI 1.35-2.27) in acute heart failure patients. Chronic heart failure patients with hypoalbuminemia exhibited a 3.5-fold (95% CI 1.29-9.73) higher risk for long-term all-cause mortality. Conclusions: Hypoalbuminemia is possibly an independent predictor of all-cause mortality in patients with acute or chronic heart failure. However, the current findings should be further confirmed in future prospective studies. Moreover, future well-designed randomized controlled trials would be required to investigate whether correcting hypoalbuminemia in heart failure patients has potential to improve survival outcome.

中文翻译：

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心力衰竭患者低蛋白血症全因死亡率的预测：一项荟萃分析。

目的：血清白蛋白水平对心力衰竭患者死亡率的预后作用受到了广泛关注。这项荟萃分析旨在检验低白蛋白血症对心力衰竭患者全因死亡率预测的预后意义。材料和方法：截至2019年3月10日，系统地搜索Pubmed和Embase数据库，以鉴定合格的研究。流行病学研究报告了对急性或慢性心力衰竭患者与白蛋白血症相关的全因死亡率进行多变量调整的风险评估。结果：10篇文章中的9篇研究涉及16,763名心力衰竭患者，被纳入最终分析。低白蛋白血症与医院内死亡率增加相关（风险比[RR] 4.90； 95％置信区间[CI] 2.96-8。10）和急性心力衰竭患者的长期全因死亡率（RR 1.75; 95％CI 1.35-2.27）。低蛋白血症的慢性心力衰竭患者长期全因死亡的风险高3.5倍（95％CI 1.29-9.73）。结论：低白蛋白血症可能是急性或慢性心力衰竭患者全因死亡率的独立预测因子。但是，当前的发现应在未来的前瞻性研究中得到进一步证实。此外，将需要未来设计良好的随机对照试验来研究纠正心力衰竭患者的低白蛋白血症是否具有改善生存结果的潜力。73）长期全因死亡率较高的风险。结论：低白蛋白血症可能是急性或慢性心力衰竭患者全因死亡率的独立预测因子。但是，当前的发现应在未来的前瞻性研究中得到进一步证实。此外，将需要未来设计良好的随机对照试验来研究纠正心力衰竭患者的低白蛋白血症是否具有改善生存结果的潜力。73）长期全因死亡的风险更高。结论：低白蛋白血症可能是急性或慢性心力衰竭患者全因死亡率的独立预测因子。但是，当前的发现应在未来的前瞻性研究中得到进一步证实。此外，将需要未来设计良好的随机对照试验来研究纠正心力衰竭患者的低白蛋白血症是否具有改善生存结果的潜力。