title: Length of hospitalization is associated with selected biomarkers (albumin and lymphocytes) and with co-morbidities: study on 4000 patients.
abstract: BACKGROUND
  Low albumin levels and low lymphocyte counts are intra hospital conditions that exert a negative influence on prognosis, healing and length of hospitalization. The study aimed to analyze the correlation between low blood levels of albumin, low lymphocytes, and length of stay. The secondary aim was to identify other co-morbidities associated with prolonged hospital stay.
  
  
  METHODS
  Retrospective pilot study was conducted by analyzing anamnestic and biochemical data, related to 4038 patients admitted to ten wards of Hospital San Paolo (Milan), collected from July 1st2012 to December 31st2012. A statistical analysis was carried out using the Correlation method, Multivariate Analysis and Regression. Lymphocyte count and co-morbidities were evaluated in the whole cohort, albumin levels in 1437 patients.
  
  
  RESULTS
  In the whole sample, low albumin levels and low lymphocyte counts were directly correlated to longer hospitalizations. The stratification of the results by department and diagnosis suggests that there is a higher correlation in certain subpopulations, and albumin shows a greater correlation with length of stay than lymphocytes. Also advanced age, high platelets, type of diagnosis, male gender and emergency admission led to longer hospitalizations.
  
  
  CONCLUSIONS
  A routine check of albumin, lymphocytes and a spectrum of significant variables can provide precious information which can eventually lead to a shorter hospital stay. Knowledge of the general health status of a patient and the possibility to estimate his/her length of hospital stay are essential information for Clinical Governance, and for the improvement of internal services of hospitals on a large scale.
authors.affiliation: 2nd Division of Medicine, Ospedale San Paolo and University of Milan, Milan, Italy.
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Pontiroli
authors.affiliation: 2nd Division of Surgery, Ospedale San Paolo and University of Milan, Milan, Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Loreggian
authors.affiliation: 2nd Division of Surgery, Ospedale San Paolo and University of Milan, Milan, Italy.
authors.forename: Marco P L
authors.initials: MPL
authors.lastname: Rovati
authors.affiliation: 2nd Division of Surgery, Ospedale San Paolo and University of Milan, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: De Patto
authors.affiliation: 2nd Division of Medicine, Ospedale San Paolo and University of Milan, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Folini
authors.affiliation: Division of Thoracic Surgery, Ospedale San Paolo and University of Milan, Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Raveglia
authors.affiliation: Department of Surgery, University of Milan, Milan, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: De Simone
authors.affiliation: Division of Thoracic Surgery, Ospedale San Paolo and University of Milan, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Baisi
authors.affiliation: Department of Surgery, University of Milan, Milan, Italy. ugo.cioffi@guest.unimi.it.
authors.forename: Ugo
authors.initials: U
authors.lastname: Cioffi
keywords: Albumin; Co-morbidities; Length of stay; Lymphocytes; Screening method