title: Cardiac and inflammatory biomarkers and in-hospital mortality in older medical patients.
abstract: OBJECTIVE
  Increasing evidence has mounted in recent years on the potential prognostic role of biomarkers out of cardiac-specific medical settings. We aimed to test whether cardiac and inflammatory biomarkers are independently associated with in-hospital mortality in older unselected medical inpatients undergoing standardized multidimensional evaluation.
  
  
  METHODS
  Observational study conducted in a metropolitan university-teaching hospital. A standardized, multidimensional analysis was carried out on all patients by using medical and hospital discharge documentation and interview results integrated with information collected from family members or caregivers.
  
  
  METHODS
  Patients older than 65 years consecutively admitted to the acute geriatric ward and to 2 acute medical wards of the hospital.
  
  
  RESULTS
  Male sex; low systolic blood pressure; APACHE score; functional impairment in activities of daily living (ADLs), instrumental ADLs, and Short Physical Performance Battery (SPPB); cognitive impairment; malnutrition; low albumin values; and elevated values of inflammatory and cardiac biomarkers were significantly associated with in-hospital mortality at univariate analysis. After multivariate analysis, male sex, low systolic blood pressure values at entry, severe cognitive impairment, and low functional performance measured by the SPPB resulted to be independently associated with in-hospital mortality.
  
  
  CONCLUSIONS
  The main finding of the present study is that these biomarkers, although associated with in-hospital mortality, do not have independent predictive significance when a comprehensive and multidimensional evaluation is conducted. The main clinical implication is that our findings should discourage the indiscriminate recourse to measurement of cardiac and inflammatory biomarkers, at least in older medical inpatients, thereby reducing a patient's hospital cost and potentially minimizing further unnecessary diagnostic procedures.
authors: Geriatric Section, Department of Medical and Surgical Disciplines, San Giovanni Battista Hospital, Torino, Italy.
authors: Monica
authors: M
authors: Comba
authors: Geriatric Section, Department of Medical and Surgical Disciplines, San Giovanni Battista Hospital, Torino, Italy.
authors: Gianfranco
authors: G
authors: Fonte
authors: Division of Geriatric, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, Regione Gonzole, Orbassano, Torino, Italy. Electronic address: gianlucaisaia@yahoo.it.
authors: Gianluca
authors: G
authors: Isaia
authors: Geriatric Section, Department of Medical and Surgical Disciplines, San Giovanni Battista Hospital, Torino, Italy.
authors: Larisa
authors: L
authors: Pricop
authors: Geriatric Section, Department of Medical and Surgical Disciplines, San Giovanni Battista Hospital, Torino, Italy.
authors: Irene
authors: I
authors: Sciarrillo
authors: Geriatric Section, Department of Medical and Surgical Disciplines, San Giovanni Battista Hospital, Torino, Italy.
authors: Giuliana
authors: G
authors: Michelis
authors: Geriatric Section, Department of Medical and Surgical Disciplines, San Giovanni Battista Hospital, Torino, Italy.
authors: Mario
authors: M
authors: Bo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis*; D003072:Cognition Disorders / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006785:Hospitals, University; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012737:Sex Factors; D013599:Systole; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: Biomarker; mortality; multidimensional