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Which laboratory malnutrition markers best predict 1-year mortality in hospitalized older adults?

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European Geriatric Medicine Aims and scope Submit manuscript

Key summery points

AbstractSection Aim

To study which laboratory malnutrition markers best predict 1-year mortality in hospitalized older adults as well as among patients at risk for malnutrition.

AbstractSection Findings

Low albumin serum levels best predict 1-year mortality in hospitalized older adults as well as among patients at risk for malnutrition, followed by low transferrin serum levels.

AbstractSection Message

Together with low albumin serum levels, low transferrin serum levels also predict mortality in hospitalized older adults.

Abstract

Purpose

To study which laboratory malnutrition markers best predict 1-year mortality in the general population of hospitalized older adults as well as among patients at risk for malnutrition.

Methods

A historical prospective study. All older adults (age ≥ 65 years) hospitalized in one geriatric department during 9 months were included. Malnutrition Universal Screening Tool (MUST) was used to determine malnutrition risk. Laboratory malnutrition markers included albumin serum levels, transferrin serum levels, total cholesterol serum levels, vitamin D serum levels, and lymphocyte count. A receiver operating characteristic (ROC) curve analysis was used to study which markers best predict 1-year mortality.

Results

Overall, 437 patients (63.2% women; mean age 84.7 years) were included. Overall, 126 (28.8%) patients died in the year following admission. ROC curve analysis showed that low albumin serum levels best predict 1-year mortality (AUC 0.721, p < 0.001), followed by low transferrin serum levels (AUC 0.661, p < 0.001) and low lymphocyte count (AUC 0.575, p = 0.016). Among 178 (40.7%) patients at risk for malnutrition, 63 (35.4%) patients died in the year following admission. ROC curve analysis showed that albumin serum levels best predict 1-year mortality in patients at risk for malnutrition (AUC 0.720, p < 0.001), followed by transferrin serum levels (AUC 0.659, p = 0.001). Regression analysis showed that low albumin serum levels were also independently associated with 1-year mortality among the whole cohort and among patients at risk for malnutrition (OR 0.2, 95% CI 0.1–0.4, p < 0.001, for both).

Conclusions

Low albumin serum levels best predict 1-year mortality in hospitalized older adults, followed by low transferrin serum levels.

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Authors and Affiliations

  1. Geriatrics Division, Sheba Medical Center, 5265601, Tel HaShomer, Israel

    Maias Abd-Elraheem, Marina Ioffe, Anjelika Kremer & Dan Justo

  2. Internal Medicine T, Sourasky Medical Center, Tel Aviv, Israel

    Noa Mashav

  3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Dan Justo

Authors
  1. Maias Abd-Elraheem
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  2. Noa Mashav
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  3. Marina Ioffe
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  4. Anjelika Kremer
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  5. Dan Justo
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Corresponding author

Correspondence to Dan Justo.

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The authors declared that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Sheba’s Helsinki committee for human and animal trials and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Data were obtained retrospectively, de-identified, and analyzed anonymously. Hence, informed consent was not obtained from the patients.

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Abd-Elraheem, M., Mashav, N., Ioffe, M. et al. Which laboratory malnutrition markers best predict 1-year mortality in hospitalized older adults?. Eur Geriatr Med 10, 619–624 (2019). https://doi.org/10.1007/s41999-019-00204-1

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  • DOI: https://doi.org/10.1007/s41999-019-00204-1

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