title: Prealbumin is not sensitive indicator of nutrition and prognosis in critical ill patients.
abstract: 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.
authors.affiliation: Department of Pharmacy, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-gu, Seoul 135-720, Korea.
authors.forename: Seung Hui
authors.initials: SH
authors.lastname: Lim
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Chae
authors.forename: Bo Sook
authors.initials: BS
authors.lastname: Ahn
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Chang
authors.forename: Cheung Soo
authors.initials: CS
authors.lastname: Shin
mesh_terms: 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
chemical_list: D015415:Biomarkers; D011228:Prealbumin
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