Prealbumin is not sensitive indicator of nutrition and prognosis in critical ill patients.
It was reported that 30-50% of inpatients are in a malnutrition status. Measuring the prealbumin level is a sensitive and cost-effective method for assessing the severity of illness in critically or chronically ill patients. However it is uncertain whether or not the prealbumin level correlates with the level of nutrition support and outcomes in critically ill patients. The aim of this study was to evaluate serum prealbumin level as an indicator of the effectiveness of nutrition support and the prognosis in critically ill patients. Forty-four patients who received total parenteral nutrition for more than 7 days at an intensive care unit (ICU) were studied. The serum prealbumin was measured at the initial time of nutrition support and at the almost seventh day since the first measurement. The patients were allocated into two groups. In Group 1 (n=31) and 2 (n=13), the prealbumin level increased and decreased, respectively. Age, APACHE II score, nutrition status, nutritional requirement and amount of supply, mortality, hospital day and ICU day in the two groups were compared. The serum prealbumin level increased in 31 out of the 44 patients. The average calorie intake was 1334 Kcal/day (83% of energy requirement) in Group 1 and 1170 kcal/day (76% of energy requirement) in Group 2 (p=0.131). The mortality was 42% in Group 1 and 54% in Group 2 (p=0.673). The average hospital day/ ICU day in Groups 1 and 2 were 80 days/38 days and 60 days/31 days respectively. In conclusion, in critically ill patients, the serum prealbumin level did not respond sensitively to nutritional support. In addition an increase in the prealbumin level dose not indicate a better prognosis for critically ill patients.
Lim
Seung Hui
SH
Department of Pharmacy, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-gu, Seoul 135-720, Korea.
Lee
Jong Seok
JS
Chae
Sang Hee
SH
Ahn
Bo Sook
BS
Chang
Dong Jin
DJ
Shin
Cheung Soo
CS
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000175:diagnosis*; D008875:Middle Aged; D015596:Nutrition Assessment; D011228:Prealbumin / Q000378:metabolism*; D011379:Prognosis; D012680:Sensitivity and Specificity
D015415:Biomarkers; D011228:Prealbumin
Nutrition. 1996 Apr;12(4):255-9
8862531
Int Surg. 1997 Jul-Sep;82(3):301-6
9372379
Am J Clin Nutr. 1988 Feb;47(2 Suppl):352-6
3124596
Am J Clin Nutr. 1978 Mar;31(3):429-35
415592
JPEN J Parenter Enteral Nutr. 1997 May-Jun;21(3):133-56
9168367
Am J Kidney Dis. 2001 Dec;38(6):1358-64
11728975
J Clin Endocrinol Metab. 1988 Oct;67(4):682-8
3417847
Clin Chem Lab Med. 1999 Feb;37(2):91-6
10219494
Clin Nutr. 1990 Aug;9(4):179-84
16837353
Anal Chem. 1995 Jun 15;67(12):429R-436R
8686865
J Am Diet Assoc. 1996 Apr;96(4):370-3
8598438
J Clin Invest. 1972 May;51(5):1125-34
4623165
Pediatrics. 1958 Jul;22(1, Part 1):72-9
13553607
BMJ. 1994 Apr 9;308(6934):945-8
8173401
Nutrition. 1996 Jul-Aug;12(7-8):479-84
8878138