Prealbumin serum concentrations as a useful tool in the assessment of malnutrition in hospitalized patients.
BACKGROUND
Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status.


METHODS
We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI).


RESULTS
According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI.


CONCLUSIONS
We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.
Devoto
Gianluigi
G
Laboratory Department, Ospedale di Lavagna, Lavagna, Italy.
Gallo
Fabrizio
F
Marchello
Concetta
C
Racchi
Omar
O
Garbarini
Roberta
R
Bonassi
Stefano
S
Albalustri
Giorgio
G
Haupt
Enrico
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D009752:Nutritional Status; D011228:Prealbumin / Q000032:analysis*; D012680:Sensitivity and Specificity; D044967:Serum
D015415:Biomarkers; D011228:Prealbumin