老年创伤患者入院时的低白蛋白血症与院内并发症发生率增加有关。
Hypoalbuminemia at admission is associated with increased incidence of in-hospital complications in geriatric trauma patients.
作者信息
Garwe Tabitha, Albrecht Roxie M, Stoner Julie A, Mitchell Stephanie, Motghare Prasenjeet
机构信息
Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK 73104, USA.
Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
出版信息
Am J Surg. 2016 Jul;212(1):109-15. doi: 10.1016/j.amjsurg.2015.06.013. Epub 2015 Aug 12.
BACKGROUND
Elderly patients are at an increased risk of protein-energy malnutrition (PEM) which increases the risk of morbidity/mortality. We evaluated the association between hypoalbuminemia at the time of emergency department (ED) admission and in-hospital complications among geriatric trauma patients.
METHODS
This was an ambidirectional cohort study of geriatric (≥55 years) trauma patients treated at a Level I trauma center between May 2013 and March 2014. The exposure of interest was albumin level at ED admission (<3.6 g/dL [PEM] or ≥3.6 g/dL (No PEM)]. The outcome of interest was 30-day incidence of complications.
RESULTS
A total of 130 patients met study eligibility. Of these, 85 (65%) patients were in the PEM group. After adjusting for tube feeding and injury severity score, PEM at admission was associated with a 2-fold increase in the risk of 30-day overall hospital complications (hazard ratio 2.1, 95% confidence interval 1.1 to 3.8).
CONCLUSION
Serum albumin level at ED admission, but not prealbumin level, is a significant predictor of in-hospital complications in geriatric trauma patients.
背景
老年患者发生蛋白质-能量营养不良（PEM）的风险增加，这会增加发病/死亡风险。我们评估了急诊科（ED）入院时低白蛋白血症与老年创伤患者院内并发症之间的关联。
方法
这是一项对2013年5月至2014年3月在一级创伤中心接受治疗的老年（≥55岁）创伤患者进行的双向队列研究。感兴趣的暴露因素是ED入院时的白蛋白水平（<3.6 g/dL [PEM]或≥3.6 g/dL（无PEM）]。感兴趣的结局是30天并发症发生率。
结果
共有130名患者符合研究资格。其中，85名（65%）患者在PEM组。在调整管饲和损伤严重程度评分后，入院时的PEM与30天总体院内并发症风险增加2倍相关（风险比2.1，95%置信区间1.1至3.8）。
结论
ED入院时的血清白蛋白水平而非前白蛋白水平是老年创伤患者院内并发症的重要预测指标。
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