@article{22468,
  author = {Finfer Simon and Flower O. and Suarez J. and Martin R. and Hohmann S. and Calvillo E. and Bershad E. and Rao C. and Georgiadis A. and Zygun D.},
  title = {Human Albumin Use in Adults in U.S. Academic Medical Centers},
  abstract = {<p>
OBJECTIVE: To determine rates and predictors of albumin administration, and estimated costs in hospitalized adults in the United States. DESIGN: Cohort study of adult patients from the University HealthSystem Consortium database from 2009 to 2013. SETTING: One hundred twenty academic medical centers and 299 affiliated hospitals. PATIENTS: A total of 12,366,264 hospitalization records. INTERVENTIONS: Analysis of rates and predictors of albumin administration, and estimated costs. MEASUREMENTS AND MAIN RESULTS: Overall the proportion of admissions during which albumin was administered increased from 6.2% in 2009 to 7.5% in 2013; absolute difference 1.3% (95% CI, 1.30-1.40%; p &lt; 0.0001). The increase was greater in surgical patients from 11.7% in 2009 to 15.1% in 2013; absolute difference 3.4% (95% CI, 3.26-3.46%; p &lt; 0.0001). Albumin use varied geographically being lowest with no increase in hospitals in the North Eastern United States (4.9% in 2009 and 5.3% in 2013) and was more common in bigger (&gt; 750 beds; 5.2% in 2009 and 7.3% in 2013) compared to smaller hospitals (&lt; 250 beds; 4.4% in 2009 to 6.2% in 2013). Factors independently associated with albumin use were appropriate indication for albumin use (odds ratio, 65.220; 95% CI, 62.459-68.103); surgical admission (odds ratio, 7.942; 95% CI, 7.889-7.995); and high severity of illness (odds ratio, 8.933; 95% CI, 8.825-9.042). Total estimated albumin cost significantly increased from $325 million in 2009 to $468 million in 2013; (absolute increase of $233 million), p value less than 0.0001. CONCLUSIONS: The proportion of hospitalized adults in the United States receiving albumin has increased, with marked, and currently unexplained, geographic variability and variability by hospital size.
</p>
},
  year = {2016},
  journal = {Critical Care Medicine},
  edition = {2016/09/16},
  isbn = {1530-0293 (Electronic)<br/>0090-3493 (Linking)},
  note = {Suarez, Jose I<br/>Martin, Renee H<br/>Hohmann, Samuel F<br/>Calvillo, Eusebia<br/>Bershad, Eric M<br/>Venkatasubba Rao, Chethan P<br/>Georgiadis, Alexandros<br/>Flower, Oliver<br/>Zygun, David<br/>Finfer, Simon<br/>Crit Care Med. 2016 Sep 14.},
  language = {Eng},
}