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

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.

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.

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).

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