Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus

Background: This study was designed to investigate the clinical significance of hypoalbuminemia as a marker of severity and mortality in patients with Scrub typhus. Methods: The patients with scrub typhus were divided into two groups based on the serum albumin levels; Group I (serum albumin <3.0 g/dL) and Group II (serum albumin >= 3.0 g/dL). The outcome of patients with hypoalbuminemia was compared with that of normoalbuminemia. Results: Of the total 246 patients who underwent the study, 84 patients (34.1%) were categorized as Group I and 162 patients were (65.9%) as Group II. Group I showed significantly higher incidence of confusion (24.6% vs. 5.3%, p < 0.001), pulmonary edema (15.8% vs. 3.2%, p = 0.002), pleural effusion (22.8% vs. 11.1%, p = 0.03), arrhythmia (12.3% vs. 2.6%, p = 0.008) and non-oliguric acute renal failure (40.4% vs. 11.1%, p < 0.001) compared to group II. Hypoalbuminemic group had a higher APACHE II score (11.37 +/- 5.0 vs. 6.94 +/- 4.2, p < 0.001), longer hospital stay (19.9 +/- 42.1 days vs 7.5 +/- 13.8 days, p = 0.012), and higher hospital cost compared to Group II. Conclusions: This study showed hypoalbuminemia in scrub typhus was closely related to the frequency of various complication, longer hospital stay, consequently the higher medical cost, necessitating more efficient management of patients, including medical resources.