scholarly journals Low serum albumin and total lymphocyte count as predictors of 30 day hospital readmission in patients 65 years of age or older

2015 ◽  
Author(s):  
Robert Robinson
Keyword(s):  
Risk Factor ◽  
Serum Albumin ◽  
Hospital Readmission ◽  
Lymphocyte Count ◽  
Protein Energy Malnutrition ◽  
Total Lymphocyte Count ◽  
Total Lymphocyte ◽  
Protein Energy ◽  
Patients At Risk ◽  
Low Serum

Introduction: Hospital readmission within 30 days of discharge is a target for health care cost savings through the medicare Value Based Purchasing initiative. Because of this focus, hospitals and health systems are investing considerable resources into the identification of patients at risk of hospital readmission and designing interventions to reduce the rate of hospital readmission. Malnutrition is a known risk factor for hospital readmission. Materials and Methods: All medical patients 65 years of age or older discharged from Memorial Medical Center from January 1, 2012 to March 31, 2012 who had a determination of serum albumin level and total lymphocyte count on hospital admission were studied retrospectively. Admission serum albumin levels and total lymphocyte counts were used to classify the nutritional status of all patients in the study. Patients with a serum albumin less than 3.5 grams/dL and/or a TLC less than 1,500 cells per mm3 were classified as having protein energy malnutrition. The primary outcome investigated in this study was hospital readmission for any reason within 30 days of discharge. Results: The study population included 1,683 hospital discharges with an average age of 79 years. The majority of the patients were female (55.9%) and had a DRG weight of 1.22 (0.68). 219 patients (13%) were readmitted within 30 days of hospital discharge. Protein energy malnutrition was common in this population. Low albumin was found in 973 (58%) patients and a low TLC was found in 1,152 (68%) patients. Low albumin and low TLC was found in 709 (42%) of patients. Kaplan-Meier analysis shows any laboratory evidence of PEM is a significant (p < 0.001) predictor of hospital readmission. Low serum albumin (p < 0.001) and TLC (p = 0.018) show similar trends. Cox proportional-hazards regression analysis showed low serum albumin (Hazard Ratio 3.27, 95% CI: 2.30-4.63) and higher DRG weight (Hazard Ratio 1.19, 95% CI: 1.03-1.38) to be significant independent predictors of hospital readmission within 30 days. Discussion: This study investigated the relationship of PEM to the rate of hospital readmission within 30 days of discharge in patients 65 years of age or older. These results indicate that laboratory markers of PEM can identify patients at risk of hospital readmission within 30 days of discharge. This risk determination is simple and identifies a potentially modifiable risk factor for readmission: protein energy malnutrition.

scholarly journals Low serum albumin and total lymphocyte count as predictors of 30 day hospital readmission in patients 65 years of age or older

2015 ◽  
Author(s):  
Robert Robinson
Keyword(s):  
Risk Factor ◽  
Serum Albumin ◽  
Hospital Readmission ◽  
Lymphocyte Count ◽  
Protein Energy Malnutrition ◽  
Total Lymphocyte Count ◽  
Total Lymphocyte ◽  
Protein Energy ◽  
Patients At Risk ◽  
Low Serum

Introduction: Hospital readmission within 30 days of discharge is a target for health care cost savings through the medicare Value Based Purchasing initiative. Because of this focus, hospitals and health systems are investing considerable resources into the identification of patients at risk of hospital readmission and designing interventions to reduce the rate of hospital readmission. Malnutrition is a known risk factor for hospital readmission. Materials and Methods: All medical patients 65 years of age or older discharged from Memorial Medical Center from January 1, 2012 to March 31, 2012 who had a determination of serum albumin level and total lymphocyte count on hospital admission were studied retrospectively. Admission serum albumin levels and total lymphocyte counts were used to classify the nutritional status of all patients in the study. Patients with a serum albumin less than 3.5 grams/dL and/or a TLC less than 1,500 cells per mm3 were classified as having protein energy malnutrition. The primary outcome investigated in this study was hospital readmission for any reason within 30 days of discharge. Results: The study population included 1,683 hospital discharges with an average age of 79 years. The majority of the patients were female (55.9%) and had a DRG weight of 1.22 (0.68). 219 patients (13%) were readmitted within 30 days of hospital discharge. Protein energy malnutrition was common in this population. Low albumin was found in 973 (58%) patients and a low TLC was found in 1,152 (68%) patients. Low albumin and low TLC was found in 709 (42%) of patients. Kaplan-Meier analysis shows any laboratory evidence of PEM is a significant (p < 0.001) predictor of hospital readmission. Low serum albumin (p < 0.001) and TLC (p = 0.018) show similar trends. Cox proportional-hazards regression analysis showed low serum albumin (Hazard Ratio 3.27, 95% CI: 2.30-4.63) and higher DRG weight (Hazard Ratio 1.19, 95% CI: 1.03-1.38) to be significant independent predictors of hospital readmission within 30 days. Discussion: This study investigated the relationship of PEM to the rate of hospital readmission within 30 days of discharge in patients 65 years of age or older. These results indicate that laboratory markers of PEM can identify patients at risk of hospital readmission within 30 days of discharge. This risk determination is simple and identifies a potentially modifiable risk factor for readmission: protein energy malnutrition.

Serum albumin and total lymphocyte count as predictors of outcome in hip fractures

2010 ◽  
Vol 29 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Brendan J. O'Daly ◽  
James C. Walsh ◽  
John F. Quinlan ◽  
Gavin A. Falk ◽  
Robert Stapleton ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Hip Fractures ◽  
Lymphocyte Count ◽  
Total Lymphocyte Count ◽  
Predictors Of Outcome ◽  
Total Lymphocyte

scholarly journals CONUT: A Useful Alarm of Malnutrition in the Centralized Laboratory of a Spanish Hospital

2018 ◽  
Vol 3 (4) ◽  
pp. 113-117
Author(s):  
Miriam Menacho-Román ◽  
Gilberto Pérez-López ◽  
José Manuel del Rey-Sánchez ◽  
Domingo Ly-Pen ◽  
Antonio Becerra-Fernández
Keyword(s):  
Serum Albumin ◽  
Total Cholesterol ◽  
Lymphocyte Count ◽  
Outpatient Setting ◽  
Total Lymphocyte Count ◽  
University Hospital ◽  
Severe Malnutrition ◽  
Total Lymphocyte ◽  
The University ◽  
Ramón Y Cajal

Background: Hospital malnutrition, usually secondary to various diseases and their treatments, is an important problem in our clinical practice. For its proper assessment, it is crucial to use a nutritional alert system, such as the CONUT (COntrol NUTrition) program; this tool uses 3 analytical parameters: serum albumin, total cholesterol, and total lymphocyte count. Objective: The current study assessed the results of the implementation of this program in the University Hospital Ramón y Cajal. Methods: The CONUT program has been used in the University Hospital Ramón y Cajal since 2013. This retrospective study, throughout 2016, was conducted in the Central Laboratory of Chemical Biochemistry at the University Hospital Ramón y Cajal. All blood tests with serum albumin, total cholesterol, and total lymphocyte count were studied. The degree of malnutrition was assessed using the scale of normal (=0), mild (=4), moderate (=8), and severe (=12). Results: In 2016, there were 405406 analytics performed in the laboratory of University Hospital Ramón y Cajal. The CONUT tool was applied to 3.64% of them (14741 analytics). In the outpatient setting, the highest malnutrition index comprised patients from the liver transplant consultation department, followed by the cardiology, rheumatology, and oncology departments. With inpatients, the hematology, cardiology, and endocrinology departments showed the most severe malnutrition index. Conclusion: The CONUT system seemed to provide useful information about the cohort of the studied hospital. The results showed that 94% of the patients were not classified with malnutrition, there was no gender predilection, and they were younger than the rest. Patients with more severe malnutrition were usually older and male.

Correlation of Preoperative Nutritional Status and Postoperative Wound Infection in Children

2020 ◽  
Vol 23 (2) ◽  
pp. 48-53
Author(s):  
Partha Sarathy Majumder ◽  
Anuradha Karmaker ◽  
Md Nooruzzaman ◽  
Zahidur Rahman ◽  
Syed Abdul Adil ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Wound Infection ◽  
Lymphocyte Count ◽  
Total Lymphocyte Count ◽  
Postoperative Wound Infection ◽  
Postoperative Wound ◽  
Malnourished Children ◽  
Total Lymphocyte ◽  
Low Bmi

Background: Despite improvements in antimicrobial therapy, surgical technique and postoperative care, wound infection is still a major concern in pediatric surgical practice particularly in developing countries like Bangladesh. Objective: This study was conducted to ascertain the relationship between the preoperative nutritional status and postoperative wound infection in children as malnutrition is very prevalent among them. It was also decided to estimate the rate of wound infection in children and to identify the indicator of malnutrition that best predicts wound infection. Methods: This prospective study was carried out in the Department of Pediatric Surgery, BSMMU, Dhaka during the period of January 2009 to September 2010 and included consecutive 100 children undergoing routine surgery. Nutritional status was assessed by measuring BMI, serum albumin, haemoglobin and total lymphocyte count and thus children were categorized preoperatively. The children were assessed during the first 30 postoperative days for the evidence of wound infection that were confirmed by culture and sensitivity. Results: We found most of the wound infections among the malnourished children with low BMI and low serum albumin. Conclusion: Preoperative good nutritional status is associated with less postoperative wound infection and BMI and serum albumin are good indicators but total lymphocyte count and haemoglobin are not good indicators of protein calorie malnutrition and serum albumin is the best predictor of wound infection. Journal of Surgical Sciences (2019) Vol. 23(2): 48-53

scholarly journals Low Serum Albumin Level is Risk Factor for Patients with Percutaneous Endoscopic Gastrostomy

2010 ◽  
Vol 49 (21) ◽  
pp. 2283-2288 ◽  
Author(s):  
Naoyuki Tominaga ◽  
Ryo Shimoda ◽  
Ryuichi Iwakiri ◽  
Nanae Tsuruoka ◽  
Yasuhisa Sakata ◽  
...  
Keyword(s):  
Risk Factor ◽  
Serum Albumin ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Endoscopic Gastrostomy ◽  
Low Serum
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