scholarly journals Ten-year all-cause mortality in hospitalized non-surgical patients based on nutritional status screening

2015 ◽  
Vol 18 (14) ◽  
pp. 2609-2614 ◽  
Author(s):  
Viera Kissova ◽  
Jaroslav Rosenberger ◽  
Maria Goboova ◽  
Adrian Kiss
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Cox Regression ◽  
Albumin Level ◽  
Medical Patients ◽  
Chronic Patients ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Co Morbidity

AbstractObjectiveMalnutrition is common in patients admitted to hospital due to acute illness and contributes to negative patient outcomes. In Slovakia there is a lack of relevant data on malnutrition in hospitalized patients, particularly based on chronic co-morbidity and survival. The aim of the present study was to explore the prevalence of malnutrition in hospitalized chronic patients, its relationship to co-morbidity and its impact on 10-year survival.DesignRetrospective cohort study.SettingNutritional status was estimated by Subjective Global Assessment (SGA), BMI and serum albumin level. Survival was assessed from the National Insurance Registry over a 10-year period. The association between nutritional status measured by SGA and 10-year survival controlling for age, gender, BMI and serum albumin was analysed using Cox regression.SubjectsData were taken from the medical records of 202 consecutively admitted chronic patients.ResultsMedian age was 63·5 years; 55·4 % were males; median BMI was 25·9 kg/m2; median serum albumin level was 39·0 g/l. Based on SGA evaluation, 38·1 % did not have sufficient nutritional status (SGA classification B and C). Malnutrition was more common in patients who were older (P=0·023), with lower BMI (P<0·001), who had gastrointestinal (P=0·049) and oncologic co-morbidity (P=0·021) and lower albumin level (P=0·049). In-hospital mortality was 3 %, but during the following 10 years 52 % died. Cox regression analysis controlling for age, gender, BMI and serum albumin showed that SGA was an independent predictor of death (hazard ratio=1·55; 95 % CI 1·04, 2·32; P=0·031).ConclusionsSGA is a simple screening tool that can be routinely used in hospitalized Slovak medical patients to predict the risk of death. Improving patient nutrition could thus reduce mortality.

Impact of Nutritional Status on Peritonitis in CAPD Patients

2007 ◽  
Vol 27 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Narayan Prasad ◽  
Amit Gupta ◽  
Raj K. Sharma ◽  
Archna Sinha ◽  
Ramesh Kumar
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Risk Index ◽  
Univariate Analysis ◽  
Albumin Level ◽  
Calorie Intake ◽  
Cox Regression Analysis ◽  
Nutritional Risk Index ◽  
The Impact

Objective To determine the impact of nutritional status on peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) in a developing country. Methods 56 patients with end-stage renal disease on CAPD were randomly selected for this study. These patients were assessed for nutritional status and peritonitis episodes. Nutritional parameters were assessed by anthropometry, diet, body mass index (BMI), Nutritional Risk Index (NRI), serum albumin level, and Subjective Global Assessment (SGA). Based on SGA, patients were categorized into either group 1 (malnutrition, n = 31) or group 2 (normal nutritional status, n = 25). Peritonitis was considered the primary outcome and was compared between the two groups. Results Demographic profiles, Kt/V, creatinine clearance, and mean follow-up of the two groups were similar. Number of peritonitis episodes was significantly higher in patients with malnutrition (25/31) compared to patients with normal nutritional status (4/25) ( p = 0.001). Mean peritonitis rate per patient per year was also significantly higher in patients with malnutrition (0.99 ± 1.07) compared to patients with normal nutritional status (0.18 ± 0.42) ( p = 0.007). On univariate analysis, malnutrition based on SGA ( p = 0.009), NRI ( p = 0.02), serum albumin level ( p = 0.005), and calorie intake ( p = 0.006) was a significant predictor of peritonitis. On multivariate Cox regression analysis, only SGA ( p = 0.001, odds ratio 0.08, 95% confidence interval 0.02 – 0.36) was found to be a significant predictor of peritonitis. On general linear model, the observed power of prediction of peritonitis was 0.96 based on SGA. On Kaplan–Meier survival analysis, peritonitis-free survival in patients with normal nutrition (42 months) was significantly higher compared to patients with malnutrition (21 months) based on SGA (log rank p = 0.003). Conclusion We conclude that peritonitis rate is high in patients with malnutrition and that malnutrition indices, especially SGA, can predict the peritonitis rate in CAPD patients.

scholarly journals The Level of Serum Albumin Is Associated with Renal Prognosis in Patients with Diabetic Nephropathy

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Junlin Zhang ◽  
Rui Zhang ◽  
Yiting Wang ◽  
Hanyu Li ◽  
Qianqian Han ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Diabetic Nephropathy ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Cox Regression ◽  
Albumin Level ◽  
Renal Outcome ◽  
Cox Regression Analysis ◽  
Severe Group ◽  
Renal Prognosis

Objective. Although hypoalbuminemia is frequently found in most patients with diabetic nephropathy (DN), its relationship to the severity and progression of DN remains largely unknown. Our aim was to investigate the association between the serum albumin levels and clinicopathological features and renal outcomes in patients with type 2 diabetes mellitus (T2DM) and biopsy-proven DN.Materials and Methods. A total of 188 patients with T2DM and biopsy-proven DN followed up for at least one year were enrolled. The patients were divided into four groups based on the albumin levels: normal group: ≥35 g/L (n=87); mild group: 30-35 g/L (n=34); moderate group: 25-30 g/L (n=36); and severe group: <25 g/L (n=31). The renal outcome was defined by progression to end-stage renal disease. The impact of the serum albumin level on renal survival was estimated using Cox regression analysis.Results. Among the cases, the serum albumin level had a significant correlation with proteinuria, renal function, and glomerular lesions. A multivariate Cox regression analysis indicated that the severity of hypoalbuminemia remained significantly associated with an adverse renal outcome, independent of clinical and histopathological features. In reference to the normal group, the risk of progression to ESRD increased such that the hazard ratio (HR) for the mild group was 2.09 (95% CI, 0.67-6.56,p=0.205), 6.20 (95% CI, 1.95-19.76,p=0.002) for the moderate group, and 7.37 (95% CI, 1.24-43.83,p=0.028) for the severe group.Conclusions. These findings suggested that hypoalbuminemia was associated with a poorer renal prognosis in patients with T2DM and DN.

scholarly journals In maintenance hemodialysis patients, there were “U-shaped” relationships between serum albumin level and mortality or hospitalization, negative linear relationship between serum albumin level and hospitalization for infection.

2019 ◽  
Author(s):  
Xiaoyan Jia ◽  
Ping Chen ◽  
Xue Wang ◽  
Xianglei Kong ◽  
Juan Chen ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Cerebrovascular Disease ◽  
Linear Relationship ◽  
Serum Albumin Level ◽  
Cox Regression ◽  
Albumin Level ◽  
Maintenance Hemodialysis ◽  
Linear Association ◽  
Non Linear ◽  
Negative Linear Relationship

Abstract Background: Few studies are available on the non-linear association between serum albumin (S-Alb) level and prognosis in maintenance hemodialysis (MHD) patients. Methods: All stable MHD patients treated in our center from 2007 to 2011 were enrolled into this study. Demographics, laboratory data, hospitalization and mortality were collected; Cox regressive models were fitted to investigate predicting outcomes, restricted cubic splines (RCS) were allowing for non-linear association between S-Alb and prognosis. Results: S-Alb was independent protective factor for mortality, all-cause hospitalization, hospitalization for cardiovascular or cerebrovascular disease and hospitalization for infection. The relationships between S-Alb and mortality, all-cause hospitalization, hospitalization for cardiovascular or cerebrovascular disease were U-shaped; relationships between S-Alb and hospitalization for infection were negative linear relationships both in univariable Cox regression models and in multivariable Cox regression. Conclusions: In MHD population, there were “U-shaped” relationships between serum albumin level and mortality or hospitalization; the potential risks associated with excessive S-Alb should been taken into consideration. There was negative linear relationship between S-Alb and hospitalization for infection, S-Alb may be even more important in preventing infection in MHD population.

Nutritional Status of the Children with Acute Lymphoblastic Leukemia at Diagnosis and after Completion of Induction

2021 ◽  
Vol 5 (02) ◽  
pp. 50-56
Author(s):  
Noor-A-Sabah Liza ◽  
S. M. Rezanur Rahman ◽  
Afiqul Islam ◽  
Chowdhury Yakub Jamal ◽  
Mohosina Sultana Setu ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Induction Chemotherapy ◽  
Induction Therapy ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Anthropometric Measurements ◽  
Newly Diagnosed ◽  
Significant Difference ◽  
Nutritional Status Of Children

Background: Adequate nutrition is an important concern in children with leukemia. Malnutrition and weight lost are common and are due to verity of mechanism involving the tumor, the host response to the tumor such as infection and pharmacokinetics of chemotherapeutic drugs. Objective: To evaluate and compare the nutritional status of children with ALL at diagnosis and after completion of induction therapy. Methodology: This prospective observational study included 60 children newly diagnosed as ALL, aged 2-15 years, over a period from April 2012 to September 2012 in the Department of Pediatric Hematology and Oncology, BSMMU. The anthropometric measurements and serum albumin level were taken. Anthropometric indices are calculated by NCHS (WHO-2000) and classified as Z score. Children <-2 SD are considered as underweight (WFA), stunted (HFA) and wasted (WFH). Serum albumin level below 21g/dl is considered as severely malnourished. The Hb values of the children are compared with normal values by age. The children got induction chemotherapy according to MRC-11 protocol. They were in regular follow up and again anthropometric measurements and serum albumin level were taken after completion of induction. Results: Out of 60 children with ALL, 48 (70%) were underweight, 45 (75%) were stunted 36 (60%) were wasted at diagnosis. Incidence of malnutrition among leukemia children after completion of induction were 24 (40%) underweight, 45 (75%) were stunted and 6 (10%) were wasted. The results showed that children in the newly diagnosed stage had a higher prevalence of malnutrition. However no statistically significant difference in the nutritional status was found among newly diagnosed and after completion of induction in term of underweight and stunting but newly diagnosed patients had statistically significant wasting than patients who had completed induction chemotherapy. No patient showed severe malnutrition based on the cut-off point for serum albumin on both stages. All the children (100%) had less than normal range hemoglobin levels. Conclusion: Malnutrition was higher in children with newly diagnosed leukemia. Children had significant differences in the nutritional status in term of wasting at diagnosis than after completion of induction therapy. So, the nutritional status of children with leukemia should be monitor periodically.

Albumin Is a Prognostic Factor for Overall Survival in Newly Diagnosed Patients with Acute Myeloid Leukemia (AML)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4253-4253
Author(s):  
Awais M. Khan ◽  
Jeffrey E. Lancet ◽  
Mohamed A. Kharfan-Dabaja ◽  
Najla H Al Ali ◽  
Alan F. List ◽  
...  
Keyword(s):  
Overall Survival ◽  
Serum Albumin ◽  
Induction Chemotherapy ◽  
Serum Albumin Level ◽  
Cox Regression ◽  
Albumin Level ◽  
Normal Serum ◽  
Newly Diagnosed ◽  
Kaplan Meier ◽  
History Of

Abstract Abstract 4253 Background: Hypoalbuminemia (HA) is a strong predictor of poor clinical outcomes in many medical conditions. Low serum albumin is recognized as an adverse prognostic factor in patients with neoplastic diseases such as multiple myeloma, melanoma, and colon cancer. Severe hypoalbuminemia (<3.0 g/dl) at day +90 post allogeneic hematopoietic cell transplant (AHCT) was reported as an independent predictive variable for non-relapse mortality and overall survival (Kharfan-Dabaja, et al Biol Blood Marrow Transplant 2009; 15). A separate study conducted by our group showed that in patients with relapsed and refractory AML, serum albumin < 3.5 g/dl prior to salvage chemotherapy, correlated with lower complete remission (CR) rate and inferior overall survival (OS) (Komrokji, et al ASH 2009). We examined the prognostic value of serum albumin level prior to induction chemotherapy in patients with newly diagnosed AML. Methods: Data were collected retrospectively in a cohort of newly diagnosed AML patients who received induction chemotherapy (3+ 7 regimen). The primary objective of this study is to examine the relationship between serum albumin at baseline and probability for achieving complete remission (CR) or incomplete remission (CRi) and overall survival (OS). All analyses were conducted using SPSS version 19.0. The Kaplan–Meier method was used to estimate median overall survival; chi-square test was used for comparison of categorical variables and t-test for continuous variables. Log rank test was used to compare Kaplan–Meier survival estimates between two groups and Cox regression for multivariable analysis. Results: Between November 2004 and July 2007, 135 patients who received 3+7 induction chemotherapy at Moffitt Cancer Center were included in this analysis. Patient baseline characteristics were similar between patients with baseline serum albumin < 3.5 g/dl (HA) and those with serum albumin ≥ 3.5 g/dl (no HA) with respect to age, sex, FAB subtype, history of antecedent MDS, karyotype, and chemotherapy. Patients with HA, mean age was 60 years compared to 56.5 years in non HA group. The median OS for patients with HA was 221 days (95%CI 149.5–292.5) compared to 421 days (95%CI 236.7–605) with normal serum albumin (p<0.005). (Figure-1) The CR/CRi rate was 64%% for HA and 77.6% for those with normal albumin (p=0.09). In a multivariable Cox regression analysis including age ≥ 60 years, history of MDS, karyotype, and serum albumin level at baseline; only age, karyotype and serum albumin were independent predictors of OS [Hazard ratio 0.47 (95%CI 0.31–0.71) (p<0.005) for normal serum albumin group]. Conclusion: In this cohort of patients with newly diagnosed AML, we demonstrate that hypoalbuminemia < 3.5 g/dl is an independent covariate for overall survival with conventional chemotherapy management. Serum albumin is a surrogate marker of general health, comorbidities, and performance status. The prognostic value of low serum albumin should be validated in a prospective study. Disclosures: No relevant conflicts of interest to declare.

Evaluation of Nutritional Status and Factors Related to Malnutrition in Children on CAPD

2003 ◽  
Vol 23 (6) ◽  
pp. 557-562 ◽  
Author(s):  
Mesiha Ekim ◽  
Aydan Ikinciogullari ◽  
Betul Ulukol ◽  
Sevcan A. Bakkaloglu ◽  
Nuray Ozkaya ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Standard Deviation ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Significant Positive Correlation ◽  
Serum Albumin Level ◽  
Standard Deviation Score ◽  
Albumin Level ◽  
Upper Arm ◽  
Positive Correlations

Objective The aim of this study was to investigate the nutritional status of children on continuous ambulatory peritoneal dialysis (CAPD) and to relate it to the dose of dialysis and serum levels of inflammatory cytokines and insulin-like growth factor-1 (IGF-1). Patients 17 CAPD patients (8 girls, 9 boys; mean age 13.1 ± 3.5 years, median 15 years) were included in the study. Anthropometric measurements and serum albumin levels were used in the evaluation of nutritional status. Serum interleukin (IL)-1β, IL-6, tumor necrosis factor α, and IGF-1 levels were determined in all CAPD patients and in a healthy control group. Weekly Kt/V and creatinine clearance (CCr) were measured to determine adequacy of dialysis. Results The mean dialysis period was 23.7 ± 15.2 months (median 23 months). Anthropometric measurements and serum albumin level were as follows: height 130.2 ± 15.6 cm, height standard deviation score (HtSDS) -4.2 ± 2.4, body mass index (BMI) 16.3 ± 1.6 kg/m2, body mass index standard deviation score (BMISDS) -0.8 ± 0.9, triceps skinfold thickness (TST) 4.2 ± 1.4 mm, midarm circumference (MAC) 16.21 ± 2.3 cm, upper arm muscle area (AMA) 1799.1 ± 535.7 mm2, upper arm fat area (AFA) 334.5 ± 143 mm2, and serum albumin 3.1 ± 0.7 g/dL. The BMI was above the fifth percentile in all patients; TST and MAC were below the fifth percentile in 14 patients (82.4%) and 10 patients (58.8%) respectively. The AMA was below the fifth percentile in 8 patients; however, the AFA was below the fifth percentile in all patients. Mean serum albumin level was under 3.5 g/dL in 70.5% of the children. We found significant positive correlations between BMI and Kt/V ( r = 0.69, p < 0.01), CCr ( r = 0.64, p < 0.05), and IL-6 ( r = 0.61, p < 0.01). There was an inverse correlation between BMISDS and dialysis period ( r = -0.58, p < 0.05); and between IL-6 and serum albumin ( r = -0.49, p < 0.05). A significant positive correlation between BMISDS and serum IGF-1 level ( r = 0.62, p < 0.01) was noted. We also found a significant positive correlation between serum IGF-1 level and both HtSDS ( r = 0.57, p < 0.05) and TST ( r = 0.52, p < 0.05). Significant positive correlations between AFA and CCr and IGF-1 were also noted (both r = 0.56, p < 0.05). Conclusion Although many factors may be responsible for malnutrition and growth retardation, we found that prolonged period of dialysis, inadequate dialysis, and low IGF-1 levels are the most important risk factors in CAPD patients.

scholarly journals Impact of the Serum Level of Albumin and Self-Assessed Chewing Ability on Mortality, QOL, and ADLs for Community-Dwelling Older Adults at the Age of 85: A 15 Year Follow up Study

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3315 ◽  
Author(s):  
Yoshiaki Nomura ◽  
Erika Kakuta ◽  
Ayako Okada ◽  
Ryoko Otsuka ◽  
Mieko Shimada ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Community Dwelling ◽  
Chewing Ability ◽  
Community Dwelling Older Adults

Quality of life (QOL) and mortality are true endpoints of epidemiological or medical research, especially for community-dwelling older adults. Nutritional status and activities of daily living (ADLs) are associated with QOL and mortality. Good oral health status supports a good nutritional status. The aim of this study was to elucidate the complex structure of these important health-related factors. We surveyed 354 healthy older adults at the age of 85. Nutritional status was evaluated by the serum level of albumin. QOL, ADLs, self-assessed chewing ability, serum albumin level, and mortality during the 15 year follow up period were analyzed. Self-assessed chewing ability was associated with QOL and ADLs. Self-assessed chewing ability for slight-hard foods was associated with mortality in men. However, it was not associated with the serum albumin level. The serum albumin level was associated with mortality in women. These results indicate that maintaining good oral function is not enough. Nutritional instruction in accordance with oral function is indispensable for health promotion in older adults. When planning health promotion strategies for older adults, different strategies are needed for men and women.

The prognostic role of serum albumin in patients receiving induction chemotherapy for acute myeloid leukemia (AML).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6618-6618
Author(s):  
Hossein Sadrzadeh ◽  
Andrew Mark Brunner ◽  
Benjamin Jacob Drapkin ◽  
Loren Babirak ◽  
Lillian Werner ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Induction Chemotherapy ◽  
Serum Albumin Level ◽  
Cox Regression ◽  
Massachusetts General Hospital ◽  
Disease Free Survival ◽  
Albumin Level ◽  
Categorical Variables ◽  
Oncologic Patients ◽  
Prognostic Utility

6618 Background: Serum albumin has been investigated as a prognostic tool in the care of patients with hematologic malignancies, including multiple myeloma and myelodysplastic syndromes. However, its prognostic utility in patients with AML is unknown. We hypothesized that a lower serum albumin is associated with worse outcomes following induction chemotherapy for AML. Methods: We conducted a retrospective medical record review of 166 adult, non-promyelocytic AML patients who had received induction chemotherapy at Massachusetts General Hospital from 1992 to 2007. Patient characteristics were summarized as numbers and percentages for categorical variables. The Kaplan Meier method was used to estimate median disease-free survival (DFS) and overall survival (OS). We dichotomized our patients by serum albumin ≥3 and <3, and determined the association of albumin with 60-day survival and complete remission (CR) rate using Fisher’s exact test. Association of albumin with DFS and OS was summarized using Cox regression in both univariate and multivariable analyses. Results: Of 166 patients, 125 (75%) achieved CR and 143 (86%) were alive at 60 days following diagnosis. After risk-adjusting for age and LDH, we found that a serum albumin level <3 mg/dL was associated with decreased 60-day survival (OR 0.30, p=0.015) and CR rate (OR 0.41, p=0.02) compared to patients with serum albumin ≥3. There was no association between serum albumin and DFS (p=0.88) or OS (p=0.31). As expected, younger age was associated with better induction outcomes. Conclusions: Serum albumin was negatively associated with short-term outcomes in patients receiving induction chemotherapy. A serum albumin level less than 3, clinically relevant to oncologic patients, was associated with a significantly decreased CR rate and lower 60-day survival after induction chemotherapy. This data suggests that serum albumin, a surrogate commonly used for nutritional status and suppressed in inflammatory comorbid states, has prognostic utility for AML patients undergoing induction chemotherapy.

scholarly journals Geriatric Nutritional Risk Index and Controlling Nutritional Status Score can predict postoperative 180-day mortality in hip fracture surgeries

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Atsushi Kotera
Keyword(s):  
Hip Fracture ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Risk Index ◽  
Albumin Level ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Status Score ◽  
Nutritional Risk Index

Abstract Background The Geriatric Nutritional Risk Index (GNRI) based on serum albumin level and body weight and the Controlling Nutritional Status Score (CONUT) based on serum albumin level, total cholesterol level, and total lymphocyte count were created to evaluate objectively a patient’s nutritional status in 2005. Here we validated the usefulness of the GNRI and the CONUT as a prognostic factor of the 180-day mortality in patients who underwent hip fracture surgeries. We retrospectively collected data from patients with hip surgeries performed from January 2012 to December 2018. The variables required for the GNRI and the CONUT and the factors presumably associated with postoperative mortality including the patients’ characteristics were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity in category variables. The Mann-Whitney U test was used to test for differences in continuous variables. We validated the power of the GNRI and the CONUT values to distinguish patients who died ≤ 180 days post-surgery from those who did not, by calculating the area under the receiver operating characteristic curve (AUC). The correlation between these two models was analyzed by Spearman’s rank correlation (ρ). Results We retrospectively examined the cases of 607 patients aged 87 ± 6 (range 70–102) years old. The 180-day mortality rate was 5.4% (n = 33 non-survivors). The GNRI value in the non-survivors was 83 ± 9 (range 66–111), which was significantly lower than that in the survivors at 92 ± 9 (range 64–120). The CONUT value in the non-survivors was 6 ± 3 (range 1–11), which was significantly higher than that in the survivors at 4 ± 2 (range 0–11). The AUC value to predict the 180-day mortality was 0.74 for the GNRI and 0.72 for the CONUT. The ρ value between these two models was 0.61 in the total of 607 patients and was 0.78 in the 33 non-survivors. Conclusions Our results suggest that the GNRI and the CONUT are a simple and useful tool to predict the 180-day mortality in patients who have undergone a hip surgery.

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