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Serum Albumin and Prealbumin As Predictors of Clinical Outcomes of Hospitalized Elderly Nursing Home Residents
Author(s) -
Ferguson Robert P.,
O'Connor Patrick,
Crabtree Benjamin,
Batchelor Allison,
Mitchell Jeanne,
Coppola Devin
Publication year - 1993
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1993.tb01893.x
Subject(s) - hypoalbuminemia , medicine , transthyretin , serum albumin , cohort study , albumin , prospective cohort study , emergency medicine
Objective To investigate the prevalence of hypoalburninemia 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.