A retrospective study on the use of albumin in the management of complications of decompensated cirrhosis from a major teaching hospital in Canada
Bibliographic record
Abstract
Background: Various academic societies have recommended the use of albumin for managing ascites and its complications. This study aims to assess adherence to recommended albumin dosing and scheduling for large volume paracentesis (LVP), acute kidney injury (AKI), spontaneous bacterial peritonitis (SBP), and infections other than SBP. Clinical outcomes were correlated with albumin use. Methods: Patient demographics, past cirrhosis complications, details of albumin use, further complications and readmissions after the index event, and 6-month survival were collected. Results: 220 patients were included from March 2020 to March 2021 (68% men, mean age 61.3 [SD 12.1] y). LVP patients (n = 58) received a higher than recommended dose of albumin of 12 (SD 12) g/L of ascites drained and had the least complications at presentation or readmissions during follow-up, with a 6-month survival of 79%. SBP patients (n = 32) had a mean daily albumin dose of 48 (SD 18) g for a mean of 3.5 (SD 2.1) days, with the most complications during the index event, and more patients needing readmissions during follow-up, with the lowest survival of 28% at 6 months. All AKI patients (n = 62) received approximately 50 g/day of albumin irrespective of AKI stage. Renal recovery was inversely correlated with AKI stage. Six-month survival was 48%. The use of albumin for other infections (n = 68) was mostly for bacteremia, with a 67.7% 6-month survival. Conclusions: The use of albumin in decompensated cirrhosis does not seem to follow the recommendations as set by treatment guidelines. Formal albumin dose-response studies may help to identify the most appropriate doses of albumin for the approved indications in decompensated cirrhosis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".