Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Faculty of Medicine Bldg. No. 5-308, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Clin Nutr. 2011 Dec;30(6):738-45. doi: 10.1016/j.clnu.2011.07.003. Epub 2011 Jul 29.
BACKGROUND & AIMS: We aimed to investigate the predictive validity of serum albumin for pressure ulcer healing, according to patient condition and wound characteristics.
This study was a secondary analysis of pooled data from two multicentre cohort studies undertaken in 2005 and 2007. All adult patients with pressure ulcer were included and were tracked until wound healing or discharge from care. Baseline serum albumin data were obtained from medical charts.
A total of 2530 patients were analyzed. By multivariate Cox proportional hazards analysis, higher serum albumin level was associated with wound healing of only superficial pressure ulcers for patients in acute/postoperative conditions (hazard ratio 1.29, 95% confidence interval 1.13-1.46) and the cutoff point was 24/25 g/L. However, the addition of serum albumin level to other factors resulted in little increase in the ability to predict wound healing as measured by the overall C-statistics. For patients in chronic/palliative conditions, serum albumin level as the continuous variable was not significantly associated with ulcer healing.
The addition of serum albumin marker may not have much advantage to predict pressure ulcer healing although its level can be associated with ulcer healing, depending on patient condition and wound depth.
本研究旨在根据患者状况和伤口特征,探讨血清白蛋白对压疮愈合的预测价值。
本研究是对 2005 年和 2007 年两项多中心队列研究的汇总数据进行的二次分析。纳入所有患有压疮的成年患者,并对其进行跟踪,直至伤口愈合或出院。基线血清白蛋白数据来自病历。
共分析了 2530 例患者。多变量 Cox 比例风险分析显示,对于处于急性/术后状态的患者,较高的血清白蛋白水平仅与表浅压疮的愈合相关(风险比 1.29,95%置信区间 1.13-1.46),截断值为 24/25 g/L。然而,将血清白蛋白水平加入其他因素后,总体 C 统计量衡量的预测伤口愈合的能力增加不大。对于处于慢性/姑息治疗状态的患者,血清白蛋白水平作为连续变量与溃疡愈合无显著相关性。
虽然血清白蛋白水平与溃疡愈合有关,但根据患者状况和伤口深度,添加血清白蛋白标志物对预测压疮愈合可能没有太大优势。