Abstract
Abstract Objectives Pre-albumin (PAB) can be used to evaluate the association between nutrition status and in-hospital mortality. However, there is no literature to compare if PAB is the best indicator to predict in-hospital mortality among the nutrition indexes in a study. Methods We operated a retrospective study including 145 patients admitted to our institution’s elderly intensive care unit (ICU) from January, 2017 to December, 2019. Admission laboratory results were collected. Regression analysis and receiver operating curve (ROC) were analyzed to explore the performance of different nutrition indexes. Results The levels of PAB were significantly different between the survivor and non-survivor group (p=0.001). Univariate analysis showed nutrition indexes (lymphocytes, albumin, body mass index [BMI], geriatric nutritional risk index (GNRI), prognostic nutritional index [PNI] and PAB) were associated with in-hospital mortality (all p<0.1). Following adjustment for age, platelets and creatinine (CREA), only BMI and PAB remained statistically significant (BMI: HR 2.799, 95% CI 1.167–6.715, p=0.021; PAB: HR 6.329, 95% CI 2.660–15.151, p<0.001). In addition, PAB had the highest area under the curve (AUC) for predicting in-hospital mortality (AUC = 0.696) followed by BMI (AUC = 0.561) and other factors. Conclusions PAB is a better predictor of in-hospital mortality than other nutrition indexes in elderly ICU patients.
Highlights
Intensive care unit (ICU) patients are often coupled with one or more system dysfunctions, acute illness, immobility and impaired diet, causing poor nutrition status
PAB is a better predictor of in-hospital mortality than other nutrition indexes in elderly intensive care unit (ICU) patients
There were no significant differences in the levels of WBC, lymphocytes, neutrophils, HB, platelets, AST, albumin, CREA, body mass index (BMI), GNRI and PNI between the two groups (Table 1)
Summary
Intensive care unit (ICU) patients are often coupled with one or more system dysfunctions, acute illness, immobility and impaired diet, causing poor nutrition status. Malnutrition is common in ICU patients [1]. Persistent eating disorders and accompanied by comorbidities, leading to aggravation of malnutrition [2]. It is pointed out that malnutrition is a risk factor to predict ICU patients with poor outcomes [3]. Active and effective nutrition supplement can ameliorate the treatment effect and reduce the occurrence of complications. It is necessary to assess the nutritional status of ICU patients when admission; the levels of nutritional indices are affected by diet, inflammation or/and insufficient organ function, monitoring the nutritional status is challenging
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