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Nakou, A., Dragioti, E., Bastas, N., Zagorianakou, N., Kakaidi, V., Tsartsalis, D., et al. (2025) Loneliness, Social Isolation, and Living Alone: A Comprehensive Systematic Review, Meta-Analysis, and Meta-Regression of Mortality Risks in Older Adults. Aging Clinical and Experimental Research, 37, Article No. 29.
https://doi.org/10.1007/s40520-024-02925-1

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• TITLE: Low Serum Albumin as a Determinant of Mortality in Shock: A Systematic Review and Meta-Analysis of Global Evidence

  AUTHORS: Jackson Rashid Djuma, Claudine Malonga, Deogratias Mulungulungu, Marc Habunamboka Kilonda, Jean Charles Preiser

  KEYWORDS: Hypoalbuminemia, Shock, Mortality

  JOURNAL NAME: Open Journal of Emergency Medicine, Vol.13 No.4, November 7, 2025

  ABSTRACT: Background: Hypoalbuminemia is a hallmark of critical illness, reflecting both systemic inflammation and impaired homeostasis. This systematic review and meta-analysis examine the prognostic significance of low serum albumin in shock patients, integrating data from diverse global cohorts. Methods: Comprehensive searches of PubMed, Europe PMC, and Google Scholar were conducted (2019-2025) to identify studies reporting adjusted odds ratios (ORs) or hazard ratios (HRs) for the association between hypoalbuminemia and mortality in adult shock patients. Separate random-effects meta-analyses were performed for ORs and HRs. Heterogeneity was quantified with I2 statistics, and meta-regression was applied to explore study-level covariates. Results: Eleven studies met inclusion criteria (n = 7 OR studies; n = 4 HR studies). Pooled ORs and HRs each demonstrated a robust association between low serum albumin and increased mortality, independent of major confounders. Sensitivity analyses confirmed the stability of findings. Age significantly modified OR-based associations, while continental location showed borderline influence in HR models. Conclusions: Low serum albumin is a powerful, independent prognostic biomarker in shock. These findings reinforce albumin’s potential utility in risk stratification and therapeutic decision-making in critical care.