title: Serum prealbumin is an independent predictor of mortality in systemic sclerosis outpatients.
abstract: OBJECTIVE
  Serum prealbumin is a recognized marker of malnutrition, but its role in the prognosis of patients with SSc has not yet been investigated. The aim of the present multicentre prospective study was to investigate the association between prealbumin and mortality, independent of clinical features, in a cohort of SSc outpatients.
  
  
  METHODS
  Patients were followed up according to standard clinical guidelines with visits at least every 6 months. Data collected included records of skin and internal organ involvement, survival and causes of death.
  
  
  RESULTS
  During a median follow-up of 48 months [interquartile range (IQR) 25-58], 34/299 patients (11%) died. In univariable survival analysis, age; male sex; lung, gastrointestinal or multiple visceral organ involvement (two or more); co-morbidities (two or more) and low serum prealbumin were significant predictors of mortality. In bivariable Cox models, alternatively adjusted for significant predictors, prealbumin was independently and significantly associated with the outcome. Mortality rates were particularly influenced by low prealbumin in patients without significant co-morbidities or multiple organ involvement.
  
  
  CONCLUSIONS
  In SSc patients, low serum prealbumin is an independent predictor of mortality, particularly in those without significant internal organ involvement. Further research on this nutritional marker is warranted.
authors.affiliation: Division of Rheumatology, University of Pavia.
authors.forename: Veronica
authors.initials: V
authors.lastname: Codullo
authors.affiliation: Nutrition and Dietetics Service.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cereda
authors.affiliation: Service of Biometry and Statistics, Fondazione IRCCS Policlinico San Matteo, Pavia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.affiliation: Unit of Rheumatology and Clinical Immunology, Spedali Civili Hospital in Brescia and.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cavazzana
authors.affiliation: Clinical Biochemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Alpini
authors.affiliation: Nutrition and Dietetics Service.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bonardi
authors.affiliation: Nutrition and Dietetics Service.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Turri
authors.affiliation: Unit of Rheumatology and Clinical Immunology, Spedali Civili Hospital in Brescia and.
authors.forename: Franco
authors.initials: F
authors.lastname: Franceschini
authors.affiliation: Nutrition and Dietetics Service.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Caccialanza
authors.affiliation: Division of Rheumatology, University of Pavia.
authors.forename: Carlomaurizio
authors.initials: C
authors.lastname: Montecucco
authors.affiliation: Division of Rheumatology, University of Pavia, caporali@smatteo.pv.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Caporali
mesh_terms: D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011228:Prealbumin / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000097:blood / Q000401:mortality*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D015415:Biomarkers; D011228:Prealbumin
keywords: mortality; serum prealbumin; systemic sclerosis