Keywords
Older adults; Albumin; Mortality; Veterans
Abstract
Background: Incident Serum Albumins (SA) have been extensively studied as a prognostic indicator in community-dwelling and hospitalized older adults, but less is known about the association between SA and long-term outcomes among older patients admitted to a Recuperative Care and Rehabilitation Unit (RCRU).The study purpose was to examine the association between SA obtained at discharge from a RCRU and the risk of mortality over the subsequent 9.2 years.
Methods: This prospective cohort studyincluded383 older Veterans (mean age = 78.6±7.6 years, 98% male, and 87% white) who were discharged alive and in stable medical condition from a Department of Veterans Affairs Community Living Center RCRU with outpatient follow-up. At discharge, each subject completed a comprehensive assessment and was then monitored as an outpatient for up to 9.2 years. Associations between SA at RCRU discharge and mortality were identified utilizing Cox proportional hazards (PH) regression analyses adjusting for conditions known to confound this relationship. ;
Results: The mean (SD) discharge albumin was 3.3 g/dL (0.4). During the study, 255 subjects (67%) died. The risk of death for those with albumin 3.4 was 3.1 times higher at year 2 (HR=3.09 [95% CI, 2.14, 4.48], p<0.001), but by year 3 the risk of death between the two groups was no significant (HR=1.41 [95% CI, 0.97-2.05], p=0.074). Conclusions/Implications: Among older Veterans, SA obtained at discharge from a RCRU is significantly associated with the risk of mortality over the subsequent two years. Veterans with a low RCRU discharge SA may need more aggressive monitoring and care during this period of increased mortality risk.
Citation
Brown LM, Lensing SY, Roberson PK, Bopp MM and Sullivan DH. Serum Albumin as an Independent Predictor of Mortality among Older Veterans Discharged from Recuperative Care. SM J Nutr Metab. 2019; 5(1): 1028.