title: Hypoalbuminemia at admission is associated with increased incidence of in-hospital complications in geriatric trauma patients.
abstract: BACKGROUND
  Elderly patients are at an increased risk of protein-energy malnutrition (PEM) which increases the risk of morbidity/mortality. We evaluated the association between hypoalbuminemia at the time of emergency department (ED) admission and in-hospital complications among geriatric trauma patients.
  
  
  METHODS
  This was an ambidirectional cohort study of geriatric (≥55 years) trauma patients treated at a Level I trauma center between May 2013 and March 2014. The exposure of interest was albumin level at ED admission (<3.6 g/dL [PEM] or ≥3.6 g/dL (No PEM)]. The outcome of interest was 30-day incidence of complications.
  
  
  RESULTS
  A total of 130 patients met study eligibility. Of these, 85 (65%) patients were in the PEM group. After adjusting for tube feeding and injury severity score, PEM at admission was associated with a 2-fold increase in the risk of 30-day overall hospital complications (hazard ratio 2.1, 95% confidence interval 1.1 to 3.8).
  
  
  CONCLUSIONS
  Serum albumin level at ED admission, but not prealbumin level, is a significant predictor of in-hospital complications in geriatric trauma patients.
authors.affiliation: Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK 73104, USA. Electronic address: Tabitha-Garwe@ouhsc.edu.
authors.forename: Tabitha
authors.initials: T
authors.lastname: Garwe
authors.affiliation: Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Roxie M
authors.initials: RM
authors.lastname: Albrecht
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK 73104, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stoner
authors.affiliation: Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mitchell
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK 73104, USA.
authors.forename: Prasenjeet
authors.initials: P
authors.lastname: Motghare
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003428:Cross Infection / Q000401:mortality* / Q000503:physiopathology; D004636:Emergency Service, Hospital; D005260:Female; D015577:Geriatric Assessment; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000150:complications / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D010343:Patient Admission; D011379:Prognosis; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D012016:Reference Values; D018570:Risk Assessment; D015599:Trauma Severity Indices; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*
keywords: Complications; Geriatric trauma; Hypoalbuminemia; In-hospital; Protein–energy malnutrition