Serum albumin and prealbumin as predictors of clinical outcomes of hospitalized elderly nursing home residents.

Abstract:

OBJECTIVE:To investigate the prevalence of hypoalbuminemia and hypoprealbuminemia in hospitalized, elderly, skilled nursing facility residents and to correlate these findings with clinical outcomes. DESIGN:Prospective cohort study. SETTING:A 300-bed community hospital. PARTICIPANTS:Eighty-one hospitalized, skilled nursing facility patients, average age 83.1 years. INTERVENTIONS:None. OUTCOME MEASURES:Serum albumin and prealbumin (transthyretin) were measured at admission, mid-week, 1 week, and 1 month. Patients were followed for 90 days for the outcomes of length of hospitalization and mortality. RESULTS:The prevalence of hypoalbuminemia was 99% and of hypoprealbuminemia, 79%. Both means dropped significantly from admission to midweek nadirs of 25 g/L for albumin and 14 mg/L for prealbumin. Severe hypoalbuminemia at mid-week predicted mortality (RR = 4.1 95%, CI 2.0-8.5) and extended length of hospitalization (RR = 5.2 95%, CI 2.8-9.8). Severe hypoprealbuminemia predicted extended hospitalization (RR = 3.2, CI 1.5-6.7) but not mortality. CONCLUSIONS:Hypoalbuminemia and hypoprealbuminemia are very common in this clinical setting and vary in parallel fashion over time. Severe hypoalbuminemia was a stronger predictor than hypoprealbuminemia of 90-day mortality and extended length of stay. Serum albumin on admission was not as strong a predictor of outcomes as serum albumin at mid-week.

journal_name

J Am Geriatr Soc

authors

Ferguson RP,O'Connor P,Crabtree B,Batchelor A,Mitchell J,Coppola D

doi

10.1111/j.1532-5415.1993.tb01893.x

subject

Has Abstract

pub_date

1993-05-01 00:00:00

pages

545-9

issue

5

eissn

0002-8614

issn

1532-5415

journal_volume

41

pub_type

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