How albumin administration for cirrhosis impacts on hospital albumin consumption and expenditure

作     者：Federica Mirici-Cappa Paolo Caraceni Marco Domenicali Ernesto Gelonesi Barbara Benazzi Giacomo Zaccherini Franco Trevisani Cristina Puggioli Mauro Bernardi 

作者机构：Department of Clinical MedicineAlma MaterS tudiorumUniversity of Bologna40126 BolognaItaly UO PharmacologyS Orsola-Malpighi University Hospital40138 BolognaItaly 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2011年第17卷第30期

页      面：3479-3486页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Human serum albumin Cost analysis Livercirrhosis Critical illness Ascites 

摘      要：AIM:To assess the impact of guidelines for albumin prescription in an academic hospital,which is a referral center for liver ***:Although randomized trials and guidelines support albumin administration for some complications of cirrhosis,the high cost of albumin greatly limits its use in clinical *** 2003,a multidisciplinary panel at Sant Orsola-Malpighi University Hospital(Bologna,Italy)used a literature-based consensus method to list all the acute and chronic conditions for which albumin is indicated as first-or second-line *** in hepatology included prevention of post-paracentesis circulatory dysfunction and renal failure induced by spontaneous bacterial peritonitis,and treatment of hepatorenal syndrome and refractory *** still debated,albumin administration in refractory ascites is accepted by the Italian health care *** analyzedalbumin prescription and related costs before and after implementation of the new ***:While albumin consumption and costs doubled from 1998 to 2002,they dropped 20%after 2003,and remained stable for the following 6 *** of cirrhosis,namely refractory ascites and paracentesis,represented the predominant indications,followed by major surgery,shock,enteric diseases,and *** consumption increased significantly after guideline implementation in the liver units,whereas it declined elsewhere in the ***,extra-protocol albumin prescription was estimated as10%.CONCLUSION:Albumin administration in cirrhosis according to international guidelines does not increase total hospital albumin consumption if its use in settings without evidence of efficacy is avoided.