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Association of anemia and hypoalbuminemia in German geriatric inpatients

Relationship to nutritional status and comprehensive geriatric assessment

Zusammenhang von Anämie und Hypoalbuminämie bei deutschen stationär geriatrischen Patienten

Beziehung zum Ernährungsstatus und multidimensionalem geriatrischen Assessment („Comprehensive Geriatric Assessment“)

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Abstract

Background

Anemia and hypoalbuminemia (HA) are acknowledged independent risk factors for morbidity and mortality in geriatric patients and are associated with nutritional status and frailty. Data exist regarding the association between albumin and frailty, anemia and frailty as well as frailty and nutritional status; however, there is a lack of information on the association between HA, anemia and nutritional status in older people.

Patients and methods

This study retrospectively analyzed 626 patients admitted to a German geriatrics department (average age 81.1 years, 68.2 % female and 31.8 % male) for anemia and HA. Data from the comprehensive geriatric assessment (CGA) and from the mini-nutritional assessment (MNA) were available in all patients.

Results

Patients with anemia suffered significantly more often from HA (p < 0.001) than patients without anemia, with an odds ratio (OR) of 1.99 (95 % confidence interval CI: 1.2-3.2) and of 5.41 (CI 95 %: 2.3-12.6) in patients at risk for malnutrition and in malnourished patients, respectively. A moderately significant association was seen between hemoglobin (Hb) and albumin values (Pearson’s correlation r = 0.330; p < 0.001) as well as between albumin values and the Barthel index (Spearman’s correlation r = 0.210; p < 0.001).

Conclusion

Anemia appears to be a risk factor for HA in inpatients with malnutrition and the observed association between albumin and Hb warrants further research. Geriatric inpatients with anemia should be evaluated in terms of the presence of malnutrition risk and HA.

Zusammenfassung

Hintergrund

Anämie und Hypoalbuminämie (HA) sind bei geriatrischen Patienten bekannte unabhängige Risikofaktoren für Morbidität und Mortalität, sie stehen im Zusammenhang mit Ernährungststatus und Frailty. Es gibt Untersuchungen zum Zusammenhang zwischen Albumin und Frailty, Anämie und Frailty, sowie Frailty und dem Ernährungsstatus. Bisher fehlen jedoch Daten zu einem Zusammenhang zwischen HA, Anämie und Ernährungsstatus bei geriatrischen Patienten.

Patienten und Methoden

Retrospektive Datenanalyse von 626 stationären geriatrischen Patienten (mittleres Alter 81,1 Jahre, 68,2 % Frauen, 31,8 % Männer) hinsichtlich Anämie, HA und einem Zusammenhang mit dem Ernährungsstatus (Mini Nutritional Assessment, MNA) und dem multidimensionalen geriatrischen Assessment (Comprehensive Geriatric Assessment, CGA).

Ergebnisse

Patienten mit Anämie wiesen signifikant häufiger eine HA auf (p < 0,001) als Patienten ohne Anämie, wobei anämische Patienten mit einem Risiko für Mangelernährung eine erhöhte Chance auf eine HA hatten (OR I,9; 95 %-KI: 1,2-3,2) und Patienten mit einer Mangelernährung eine OR von 5,4 (95 %-KI: 2,3-12,6) aufwiesen. Ein moderater signifikanter Zusammenhang konnte gezeigt werden zwischen Hämoglobin (Hb) und Albumin (Pearsons Korrelationskoeffizient r = 0,330; p < 0,001) sowie zwischen Albumin und Barthel Index.

Schlussfolgerungen

Anämie scheint bei mangelernährten stationär geriatrischen Patienten ein Risikofaktor für HA zu sein, wobei der beobachtete Zusammenhang zwischen Albumin und Hb weiterer wissenschaftlicher Untersuchungen bedarf. Im klinischen Alltag sollte bei stationär geriatrischen Patienten mit Anämie eine Überprüfung auf HA erwogen werden, besonders bei drohender oder bereits bestehender Mangelernährung.

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Authors and Affiliations

  1. University of Cologne, Medical Faculty and St. Marien-Hospital, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany

    G. Röhrig MPH

  2. Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany

    I. Becker

  3. University of Cologne, Medical Faculty, Cologne, Germany

    M.C. Polidori

  4. Department of Geriatric Medicine, St. Marien-Hospital, Cologne, Germany

    R.-J. Schulz & M. Noreik

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  1. G. Röhrig MPH
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Correspondence to G. Röhrig MPH.

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G. Röhrig, I. Becker, M.C. Polidori, R.-J. Schulz and M. Noreik state that there are no conflicts of interest in connection with the content of this paper.

The ethics commission of the Cologne University Faculty of Medicine approved the study (No 11-032) and it was performed in accordance with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients included in this study.

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Röhrig, G., Becker, I., Polidori, M. et al. Association of anemia and hypoalbuminemia in German geriatric inpatients. Z Gerontol Geriat 48, 619–624 (2015). https://doi.org/10.1007/s00391-015-0872-5

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  • DOI: https://doi.org/10.1007/s00391-015-0872-5

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