Issuing of albumin solutions to Danish public hospitals - A nationwide, retrospective, observational study based on pharmacy data from 2022

BACKGROUND: Intravenous albumin is used for resuscitation and substitution but is not supported by high-certainty evidence. As clinical practice likely varies, we aimed to describe the issuing of albumin solutions across Danish public hospitals.

METHODS: We assessed issuing of intravenous albumin solutions (5% and 20%) to all Danish public hospitals in 2022. We compared the issuing of albumin relative to total amount of issued fluids (comprising colloid and isotonic crystalloid solutions) at a regional, hospital, and departmental level. We used purchasing data from Danish regional hospital pharmacies as an estimate for the issuing of fluids. Data are presented by standard descriptive summaries.

RESULTS: The total amount of fluid issued across Danish public hospitals in 2022 was 1,543,199 L, of which 14,888 L (1%) constituted albumin solutions. The issuing of albumin differed across geographical regions ranging from 0.4% to 1.6% of total fluid use. More albumin was issued to university hospitals (1.2%) than non-university hospitals (0.7%). At the departmental level, proportional issuing of albumin was highest to intensive care units (ICUs) (2.9%) followed by anaesthesia departments (2.2%), medical departments (0.8%), surgical departments (0.3%), and emergency departments (0.1%). We also found geographical differences in the proportional issuing of albumin across ICUs (from 1.1% to 5.2%) and anaesthesia departments (from 0.2% to 5.6%).

CONCLUSIONS: In this nationwide study on the issuing of albumin, we observed differences across regional, hospital, and departmental settings. Particularly, the proportional issuing of albumin solutions to ICUs and anaesthesia departments differed across geographical regions suggesting marked practice variation.