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J Am Geriatr Soc. 1993 May;41(5):545-9.

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

Author information

1
Mount Sinai Hospital, Hartford, CT.

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.

PMID:
8486890
[Indexed for MEDLINE]

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