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Published on: September 20, 2019

Serum albumin as indicator of clinical evolution in patients on parenteral nutrition. Multivariate study

J M Llop1, C Muñoz, M B Badía

  • 1Servicio de Medicina Preventiva, Unidad de Nutrición Parenteral del Servicio de Farmacia, Ciutat Sanitària i Universitària de Bellvitge, Feixa Llarga s/n, E-08907 L'Hospitalet de Llobregat, Spain.

Clinical Nutrition (Edinburgh, Scotland)
|February 13, 2001
PubMed

Insights

Low serum albumin at the start of parenteral nutrition is linked to increased mortality and nosocomial infections in certain patient groups. This finding highlights the importance of monitoring albumin levels during nutritional support.

Area of Science:

  • Clinical Nutrition
  • Biochemistry
  • Internal Medicine

Background:

  • Serum albumin concentration is a key indicator of nutritional status.
  • Hypoalbuminemia is common in patients requiring parenteral nutrition.
  • The prognostic value of initial albumin levels in this context requires further elucidation.

Purpose of the Study:

  • To investigate the association between baseline serum albumin concentration and patient outcomes.
  • To determine if initial albumin levels predict morbidity and mortality in patients receiving parenteral nutrition.
  • To explore specific risks, such as infection, renal, or hepatic failure, related to hypoalbuminemia.

Main Methods:

  • A four-year prospective cohort study involving 2321 patients.
  • Patients were categorized into twelve groups based on clinical status at parenteral nutrition initiation.
  • Multiple logistic regression models were used to analyze the relationship between initial albumin levels and outcomes.

Main Results:

  • 84% of patients (1953) presented with hypoalbuminemia.
  • Hypoalbuminemia was significantly associated with an increased risk of nosocomial infection in six models.
  • Increased mortality was observed in seven models; renal failure risk was not significant, and hepatic failure risk was limited to patients with prior hepatopathy.

Conclusions:

  • Initial serum albumin concentration is a significant predictor of mortality in patients undergoing parenteral nutrition.
  • Hypoalbuminemia is linked to increased morbidity, specifically nosocomial infections, in select patient cohorts.
  • These findings underscore the clinical relevance of assessing albumin levels before initiating parenteral nutrition.
Abstract

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