Predictive value of hypoalbuminemia - Tips from Other Journals

Date: May, 1992

Hypoalbuminemia is a nonspecific marker for a variety of diseases and has been associated with an increased length of stay during hospitalization. The serum albumin level decreases with each decade of life, and thus its value as a marker for morbidity and mortality may be reduced in elderly patients. Herrmann and colleagues conducted a study to determine the usefulness of albumin levels in predicting in-hospital death, length of hospitalization and readmission rate.

The study included 15,511 consecutive patients 40 years of age or older who had an albumin level recorded on hospital admission. The serum albumin level was analyzed with respect to length of stay, mortality and readmission within one year of initial admission. A total of 15,478 patients in whom albumin was not measured on admission served as control subjects.

A low serum albumin level was defined as less than 3.4 g per dL (34 g per L). A total of 3,241 patients (21 percent) had low albumin levels. These patients were older, were hospitalized longer and had higher death rates than patients with normal albumin levels. The mortality rate was 14 percent in the group with low albumin levels, compared with 4 percent in the group with normal albumin levels. Length of hospital stay was 14.1 days in the group with low albumin levels and 9.6 days in the group with normal levels. Twenty-nine percent of patients with low albumin levels were readmitted, compared with 26 percent of patients with normal levels. Patients who did not have a serum albumin level recorded on admission had a shorter length of stay and a lower mortality rate than patients who had their albumin level measured on admission.

The authors conclude that an admission serum albumin level less than 3.4 g per dL (34 g per L) is a strong predictor of increased mortality, increased length of stay and subsequent readmission. They believe that determination of the serum albumin level on admission may be important in assessing disease severity. (Archives of Internal Medicine, January 1992, vol. 152, p. 125. )

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