Initial Prealbumin Level and Ability to Normalize Prealbumin Are Highly Predictive of Increased Mortality and Morbidity in Elderly Trauma Patients

Abstract

SESSION TITLE: Infections in the ICU SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: To study the relationship between malnutrition and outcomes in elderly trauma patients. METHODS: A retrospective data analysis was performed on patients over the age of 65 with ISS greater than 10, admitted to the ICU for over 24 hours. Data obtained included: Age, Gender, RTS, ISS, ICU length of stay (ICU LOS), ventilator days, hospital length of stay (HLOS), survival, initial pre-albumin and ability to correct within 4 days. RESULTS: Of the 200 patients enrolled, patients were divided into 3 groups using initial prealbumin - 71 patients below 5 mg/dL, 101 patients 5-10 mg/dL, and 28 patients greater than 10 mg/dL. Of the 180 patients who were hospitalized for over 4 days, 128 patients achieved normalization of prealbumin while 52 did not. Mean age was 79.2 years. RTS was found to be decreased in patients with initial prealbumin below 5 mg/dL in comparison to the other groups (11.3 vs. 11.8 vs. 11.8, p = 0.0002), with greater ISS (25.1 vs. 18.8 vs. 19.7, p < 0.0001), ICU LOS (days) (11.3 vs. 3.9 vs. 3.0, p < 0.0001), ventilator days (7.9 vs. 0.8 vs. 0.1, p < 0.0001), HLOS (days) (17.4 vs 7.8 vs. 7.1, p < 0.0001) and decreased survival (66% vs. 95% vs. 100%, p < 0.0001). Patients with prealbumin corrected within 4 days had lower ISS (19.9 vs. 29.2, p < 0.0001), as well as reduction in ventilator days (0.9 vs. 10.1, p < 0.0001), ICU LOS (days) (4.2 vs. 13.8, p < 0.0001), HLOS (days) (8.3 vs. 21.3, p < 0.0001) and improved survival (94% vs. 63%, p < 0.0001). CONCLUSIONS: Patients with initial prealbumin below 5 mg/dL had worse clinical outcomes with regards to ICU LOS, HLOS, ventilator days and survival. Correction of prealbumin within 4 days was highly associated with improved outcomes. CLINICAL IMPLICATIONS: Initial prealbumin and ability to normalize is highly predictive of clinical outcomes. DISCLOSURE: The following authors have nothing to disclose: Krishna Akella, Sraavya Akella, Akella Chendrasekhar No Product/Research Disclosure Information