In this study, we test whether coexisting hypoalbuminemia and hyperchloremia (dual-index phenotype, DIP) and early intensive care unit (ICU) reassessment are associated with 28-day in-hospital mortality.<h4>Methods</h4>In this single-center prospective observational cohort study (January 2021-December 2025), DIP was defined as albumin <35 g/L and chloride >110 mmol/L on paired laboratories within 0-6 h of ICU admission. The gene discussed is ALB; the disease is Hypoalbuminemia.