Association of hypoalbuminemia with disease and survival in 1664 cats presenting to a tertiary teaching hospital: a retrospective case-control study
Conner C Hayes, Xiaojuan Zhu, Paolo Pazzi, Sarah M SchmidAbstract
Background
Hypoalbuminemia (HA) is associated with a higher case fatality rate in people.
Hypothesis/Objectives
To describe the affected organ systems and pathoetiologies in cats with mild (2.5-2.9 g/dL), moderate (2-2.4 g/dL), or severe (< 2 g/dL) HA, and compare hospitalization and survival times to cats without HA (wHA; ≥ 3 g/dL).
Animals
Eight hundred thirty-two HA and 832 wHA cats.
Methods
Retrospective case-control study of cats with plasma albumin concentrations measured between 2017 and 2023. Diagnoses were categorized by organ system and pathoetiology and subsequently compared among HA and wHA groups. Hospitalization and survival times were compared.
Results
HA prevalence was 32% (948/2927); 116 cats were excluded. Cats with HA were more often diagnosed with infectious (211/832, 25%) or neoplastic (198/832, 24%) pathoetiologies, and diseases affecting the hematopoietic (140/832, 17%) or multisystemic (71/832, 9%) organ systems compared to cats wHA (P < .001 for all). Cats with severe HA were more likely to have infectious diseases than all other severities (P < .001). Cats with HA had longer hospitalizations and shorter survival than wHA cats (P < .001). Cats with severe HA had significantly shorter restricted mean survival times from admission to 6 months (71 days, 95% CI 51-92 days) than wHA (144 days, 95% CI 138-149 days, P < .001), mild HA (119 days, 95% CI 111-127, P < .001), and moderate HA (108 days, 95% CI 95-122 days, P = .02) cats.
Conclusions and clinical importance
In cats with severe HA, investigation of infectious diseases should be prioritized.