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Plasma albumin and calcium concentrations, and long-term mortality in primary health care patients in Sweden.

Abstract：

OBJECTIVE:Low plasma (p)-albumin and p-calcium concentrations are associated with increased mortality in hospitalised patients. There are few studies addressing this in primary care. Low p-calcium has been associated with mortality, but it is not known whether this applies to p-albumin. Could p-albumin and p-calcium be used as markers of an increased risk of mortality? PURPOSE:To study p-albumin and p-calcium at baseline and their association with mortality after 10-14 years. DESIGN:Prospective cohort study using data from a large primary health care area and the National Swedish Cause of Death Register. SETTING:Primary health care in Skaraborg, Sweden. SUBJECTS:43,052 patients (39.1% men), ≥18 years, 60.7 ± 18.4 years with p-albumin and p-calcium concentrations registered in 2001-2005. MAIN OUTCOME MEASURES:P-albumin and p-calcium concentrations at baseline and their association with mortality after a mean follow-up period of 10.3 ± 4.0 years. RESULTS:Low p-albumin was associated with total mortality compared with normal p-albumin, greatest at lower ages (18-47 years). The hazard ratios for women and men were 3.12 (95% CI 1.27-7.70) and 4.09 (95% CI 1.50-11.14), respectively. The increased mortality was seen in both cardiovascular and malignant diseases in both women and men. In contrast, low p-calcium was not associated with increased mortality, 1.00 (95% CI 0.96-1.05). Elevated p-calcium was associated with increased mortality, 1.17 (95% CI 1.13-1.22). CONCLUSIONS:Low p-albumin could be a marker of an increased risk of mortality, especially in patients of younger ages. This finding should prompt diagnostic measures in order to identify underlying causes. KEY POINTS Low p-albumin and calcium concentrations have been associated with increased mortality in hospitalised patients, but this is unexplored in primary care patients. A low p-albumin concentration at baseline was a risk marker for mortality; highest in the younger age groups. Increased mortality in both cardiovascular and malignant diseases was seen in both men and women with low compared with normal p-albumin concentrations. Elevated but not low p-calcium concentrations were associated with increased mortality after 10-14 years of follow-up.

journal_name

Scand J Prim Health Care

journal_title

Scandinavian journal of primary health care

authors

Dalemo S,Boström KB,Hjerpe P

doi

10.1080/02813432.2020.1843809

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

430-438

issue

eissn

0281-3432

issn

1502-7724

journal_volume

pub_type

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Plasma albumin and calcium concentrations, and long-term mortality in primary health care patients in Sweden.