Serum Albumin and Prealbumin As Predictors of Clinical Outcomes of Hospitalized Elderly Nursing Home Residents

Robert P. Ferguson, Patrick O'Connor, Benjamin Crabtree, Allison Batchelor, Jeanne Mitchell, Devin Coppola

Research output: Contribution to journalArticle

Abstract

To investigate the prevalence of hypoalburninemia and hypoprealbuminemia in hospitalized, elderly, skilled nursing facility residents and to correlate these findings with clinical outcomes. Prospective cohort study. A 300‐bed community hospital. Eighty‐one hospitalized, skilled nursing facility patients, average age 83.1 years. None. Serum albumin and prealbumin (transthyretin) were measured at admission, mid‐week, 1 week, and 1 month. Patients were followed for 90 days for the outcomes of length of hospitalization and mortality. The prevalence of hypoalbuminemia was 99% and of hypoprealbuminemia, 79%. Both means dropped significantly from admission to midweek nadirs of 25 g/L for albumin and 14 mg/L for prealbumin. Severe hypoalbuminemia at mid‐week predicted mortality (RR = 4.1 95%, CI 2.0–8.5) and extended length of hospitalization (RR = 5.2 95%, CI 2.8–9.8). Severe hypoprealbuminemia predicted extended hospitalization (RR = 3.2, CI 1.5–6.7) but not mortality. Hypoalbuminemia and hypoprealbuminemia are very common in this clinical setting and vary in parallel fashion over time. Severe hypoalbuminemia was a stronger predictor than hypoprealbuminemia of 90‐day mortality and extended length of stay. Serum albumin on admission was not as strong a predictor of outcomes as serum albumin at mid‐week.

Original languageEnglish (US)
Pages (from-to)545-549
Number of pages5
JournalJournal of the American Geriatrics Society
Volume41
Issue number5
DOIs
StatePublished - May 1993

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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