Assessing The Severity Of Capillary Leak In Serious Abdominal Infection Patients By The Difference Of Hematocrit And Serum Albumin

Object:To determine whether the difference of the hematocrit(Hct) and serum al-bumin was associated with APAECHII (Acute physiology and chronic Health Ev aluation II, APACHE II) scores and SOFA (Sequential Organ Failure Assessment) scores. Then to investigate the feasibility of assessing the severity of capillary leak in serious abdominal infection patients by the difference of hematocrit and serum albumin.Method:The first part(group1)385healthy volunteers from medical examination center, First affiliated Hospital Kunming University aged20─75(mean43.0±16) yr. were selected,185males and200females.to determine hematocrit(Hct) and album-in(Alb). The second part (group II, n=50):50cases diagnosed idiopathic systemic capillary leak syndrome (SLCS), aged4─61(mean35.46±9.11)yr, were selected29males and21femaleshave been reported in the literature from January1995to Decem-ber2011. to record hematocrit(Hct) and albumin(Alb).The diagnosis of SCLS was based on documentation of recurrent attacks of hypotension, elevated hematocrit con-centrations, peripheral edema, and hypoalbuminemia without albuminuria, mon-oclonal gammopathy was not considered a mandatory criterion, but its concurrent str-engthened the diagnosis.The third part (group III, n=50))50severe abdominal Infec-tion patients, treated at Department of intensive care Medicine,First affiliated Hospit al Kunming University from March2010to December2011, aged19─86yr, includ-ing31males and29females. Hematocrit (Hct) and serum albumin(Alb) were measur-ed and patients basic condition and APACHE II (Acute physiology And Chronic He-alth Evaluation II) scores,SOFA(Sepsis relate organ failure assessment) scores and hospital mortality were recorded. Main inclusion criteria:(1) All patients were being abdominal infection primary disease in their history.(2) abdominal physical examina tion: tenderness and rebounding pain and blow sounds disappear.(3) Conform to syste-mic inflammatory response syndrome.(4) Systolic pressure <90mmHg or mean arte-rial pressure <60mmHg.Results: There was no significant difference in age and the ratio of F/M. The Hct and the difference of Hct and serum Alb were significantly higher and serum Alb were lower in group II than in group I. The Hct and serum Alb were significantly low-er and the difference of the Hct and serum Alb was higher in group HI than in group I. The difference of Hct and serum Alb and APACHE II score and SOFA score in group II were significantly correlated. The mortality increaseing with increasing the differ-ence of Hct and serum Alb.Conclusion:The difference of Hct and serum Alb is a reliable factor in assessing the severity of capillary leak in serious abdominal infection patients.