Impact of Serum Albumin on Functional Status and Hospital Outcome in Oldest-Old Inpatients

摘要

Background: Elderly adults are at a higher risk of functional decline and malnutrition, especially those who are hospitalized. The aim of this study was to investigate the impact of serum albumin levels on functional status and hospital outcome in oldest-old inpatients. Methods: All the acutely ill patients aged more than 75 years admitted to the medical center in North Taiwan from March to July in 2009 were included and their medical data were reviewed. Results: A total of 2804 admissions were included with the mean age of patients being 82.0 +/- 5.4 years. The mean activity of daily living score is 1.5 +/- 1.9 in the severe hypoalbuminemia group, 2.3 +/- 2.2 in the mild hypoalbuminemia group, and 3.8 +/- 2.3 in the normal albumin level group (p < 0.01). The average length of hospital stay is 18.8 +/- 16.0 days in the severe hypoalbuminemia group, 12.8 +/- 12.6 days in the mild hypoalbuminemia group, and 9.5 +/- 9.8 days in the normal albumin level group (p < 0.01). The in-hospital mortality rate is 25.8% in the severe hypoalbuminemia group, 6.6% in the mild hypoalbuminemia group, and 2.0% in the normal albumin level group (p < 0.01). Compared with the normal albumin group, the adjusted odds ratios of albumin level associated with in-hospital mortality were 3.9 (2.4-6.3) in the mild hypoalbuminemia group and 17.4 (10.4-28.8) in the severe hypoalbuminemia group. Conclusion: In this admission database study of oldest-old patients, lower albumin level was statistically significantly (p < 0.01) correlated with poorer functional status, longer length of hospital stay, and higher in-hospital mortality rate.