Background/Objectives: Albumin supplementation is widely used for hypoalbuminemia treatment in patients with critical illness, especially those with cirrhosis. However, studies have demonstrated that routine albumin administration is not always advantageous. We examined how albumin supplementation affects survival outcomes in patients with sepsis with hypoalbuminemia. Methods: This study was conducted by researchers in Taiwan using data from the TriNetX research platform, covering the period from 1 April 2014 to 30 April 2024. This platform aggregates real-world data from healthcare organizations worldwide. From this dataset, 1,147,433 patients who developed sepsis and hypoalbuminemia with albumin levels <3.5 g/dL were identified. The study population was stratified into two groups on the basis of whether they received albumin infusion or not. To compare outcomes, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated between propensity-score-matched patients who did and did not receive albumin supplementation. Subgroup analysis by albumin levels was conducted. Results: Albumin infusion was linked to increased risks of 30-day mortality (HR [95% CI] = 1.800 [1.774–1.827], p < 0.05), shock (HR [95% CI] = 1.436 [1.409–1.465], p < 0.05), septic shock (HR [95% CI] = 1.384 [1.355–1.415], p < 0.05), hypovolemic shock (HR [95% CI] = 1.496 [1.391–1.608], p < 0.05), cardiogenic shock (HR [95% CI] = 1.553 [1.473–1.637], p < 0.05), heart failure (HR [95% CI] = 1.098 [1.080–1.116], p < 0.05), and pulmonary edema (HR [95% CI] = 1.479 [1.438–1.520], p < 0.05). The subgroup analysis by albumin levels revealed a trend of increased mortality risk with albumin supplementation in patients with high baseline albumin levels. Conclusions: Patients with sepsis with hypoalbuminemia who received albumin supplementation exhibited high 30-day mortality rates and increased risks of shock, heart failure, and pulmonary edema compared with those who did not. These findings indicate that routine albumin administration may be linked with unfavorable outcomes in these patients.

Background: Dynapenic abdominal obesity (DAO), the coexistence of low muscle strength and abdominal obesity, may accelerate disability. However, its longitudinal association with disability remains unclear. In this study, we examined the relationship between DAO and disability in middle-aged and older adults. Methods: A systematic review and random-effects meta-analysis of prospective cohort studies was conducted to examine longitudinal associations following the PRISMA 2020 guidelines (PROSPERO: CRD42024609352). Comprehensive database searches were conducted in PubMed, Embase, MEDLINE (Ovid), CINAHL (EBSCOhost), and the Cochrane Library from database inception through 31 January 2025. To ensure that the review reflected the most recent evidence prior to manuscript submission, an updated search using the same search strategy and eligibility criteria was conducted on 31 May 2026. When multiple effect estimates were reported, the most fully adjusted estimates were selected. Because odds ratios (ORs) and hazard ratios (HRs) are different effect measures and are not directly comparable, they were analyzed separately. A random-effects model was used for quantitative synthesis. Results: Five cohort studies (n = 33,670; mean follow-up: 5.3 years) were included. Of these, four studies reported adjusted ORs and one reported an HR. DAO was associated with significantly higher odds of disability (pooled OR = 2.13, 95% CI: 1.74–2.60, I² = 0%). Subgroup analyses demonstrated significant associations across predominant population types and age groups, with ORs ranging from 2.09 to 2.18. Conclusions: DAO is associated with increased odds of future disability across population types and age groups. These findings highlight the importance of early identification of DAO and suggest that interventions targeting muscle strength and abdominal obesity represent promising strategies for disability prevention; however, their effectiveness should be confirmed in future prospective intervention studies.

Peri–immune checkpoint inhibitor (ICI) COVID-19 mRNA vaccination has been linked to improved survival in lung cancer, but time-dependent and calendar-time biases may inflate real-world estimates. Using deidentified EHR data from the TriNetX Global Network, we performed a target trial emulation–informed, time-aligned new-user study of patients initiating ICIs (Sept 2, 2020–Dec 31, 2025; no prior ICI). Peri-ICI mRNA vaccination (−100 to +100 days from first ICI) was classified as pre-only (−100 to −1), post-only (0 to +100), or none, and follow-up began at a prespecified day-100 landmark. Cohorts were balanced by 1:1 propensity score matching. After matching (analytic N=4,572 per group), peri-ICI mRNA vaccination was not associated with overall survival (HR 1.005, 95% CI 0.913–1.106) or time to next systemic treatment or death (HR 1.059, 95% CI 0.956–1.174). Pre-only versus post-only OS was near null (HR 0.92, 95% CI 0.804–1.053), with concordant sensitivity analyses.