Variables affecting mortality in patients in palliative care units: or is it still just albumin?

Abstract

Introduction: This study aimed to evaluate the relationship between biomarkers, clinical prognostic indexes, and mortality in patients without malignancy. Materials and Method: This retrospective study included patients who were followed up in palliative care units between January 2020 and January 2024. Data were collected from patients’ digital database records. Demographic characteristics, clinical features, comorbidities, main reasons, and length of hospital stay were recorded. Laboratory parameters were measured at admission. Patient outcomes were also documented. Result: The study included 416 patients. The mortality rate was 28.36% (n=118). When survivors and nonsurvivors were compared, variables including albumin, protein, white blood cells, neutrophils, C-reactive protein, procalcitonin, CRP/albumin, CRP/protein, neutrophil/lymphocyte, and platelet/lymphocyte ratios significantly affected mortality. Logistic regression analysis revealed that only the albumin level was statistically significant (0.010). It was found significant that the albumin value was below 2.76 g/dL (odds ratio 3.688; the area under the curve (AUC)=0.670, and P<.000). The sensitivity and specificity of an albumin cutoff value of 2.05 g/dL were 85% and 97%, respectively. Conclusion: Our study highlights the pivotal role of hypoalbuminaemia as the most significant predictor of mortality in patients on the palliative care unit (PCU) without malignancy. To optimise patient care in palliative settings and better tailor therapeutic interventions, we must recognise the vital role of hypoalbuminaemia as a critical risk factor. Keywords: Palliative Care; Mortality; Albumin.