title: 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.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A 300-bed community hospital.
  
  
  METHODS
  Eighty-one hospitalized, skilled nursing facility patients, average age 83.1 years.
  
  
  METHODS
  None.
  
  
  METHODS
  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.
authors: Mount Sinai Hospital, Hartford, CT.
authors: R P
authors: RP
authors: Ferguson
authors: P
authors: P
authors: O'Connor
authors: B
authors: B
authors: Crabtree
authors: A
authors: A
authors: Batchelor
authors: J
authors: J
authors: Mitchell
authors: D
authors: D
authors: Coppola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006745:Hospital Bed Capacity, 300 to 499; D017052:Hospital Mortality; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care / Q000592:standards*; D010343:Patient Admission; D011228:Prealbumin / Q000032:analysis*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D012709:Serum Albumin / Q000592:standards*; D012866:Skilled Nursing Facilities
chemical_list: D011228:Prealbumin; D012709:Serum Albumin