Cardiac and inflammatory biomarkers and in-hospital mortality in older medical patients.

Abstract:

OBJECTIVES:Increasing evidence has mounted in recent years on the potential prognostic role of biomarkers out of cardiac-specific medical settings. We aimed to test whether cardiac and inflammatory biomarkers are independently associated with in-hospital mortality in older unselected medical inpatients undergoing standardized multidimensional evaluation. DESIGN:Observational study conducted in a metropolitan university-teaching hospital. A standardized, multidimensional analysis was carried out on all patients by using medical and hospital discharge documentation and interview results integrated with information collected from family members or caregivers. PARTICIPANTS AND SETTING:Patients older than 65 years consecutively admitted to the acute geriatric ward and to 2 acute medical wards of the hospital. RESULTS:Male sex; low systolic blood pressure; APACHE score; functional impairment in activities of daily living (ADLs), instrumental ADLs, and Short Physical Performance Battery (SPPB); cognitive impairment; malnutrition; low albumin values; and elevated values of inflammatory and cardiac biomarkers were significantly associated with in-hospital mortality at univariate analysis. After multivariate analysis, male sex, low systolic blood pressure values at entry, severe cognitive impairment, and low functional performance measured by the SPPB resulted to be independently associated with in-hospital mortality. CONCLUSIONS:The main finding of the present study is that these biomarkers, although associated with in-hospital mortality, do not have independent predictive significance when a comprehensive and multidimensional evaluation is conducted. The main clinical implication is that our findings should discourage the indiscriminate recourse to measurement of cardiac and inflammatory biomarkers, at least in older medical inpatients, thereby reducing a patient's hospital cost and potentially minimizing further unnecessary diagnostic procedures.

journal_name

J Am Med Dir Assoc

authors

Comba M,Fonte G,Isaia G,Pricop L,Sciarrillo I,Michelis G,Bo M

doi

10.1016/j.jamda.2013.10.013

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

68-72

issue

1

eissn

1525-8610

issn

1538-9375

pii

S1525-8610(13)00596-3

journal_volume

15

pub_type

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