Boesiger, Fabienne; Poggioli, Alessia; Netzhammer, Claudine; Bretscher, Céline; Kaegi-Braun, Nina; Tribolet, Pascal; Wunderle, Carla; Kutz, Alexander; Lobo, Dileep N; Stanga, Zeno; Mueller, Beat; Schuetz, Philipp (2023). Changes in serum albumin concentrations over 7 days in medical inpatients with and without nutritional support. A secondary post-hoc analysis of a randomized clinical trial. European journal of clinical nutrition, 77(10), pp. 989-997. Springer Nature 10.1038/s41430-023-01303-w
|
Text
s41430-023-01303-w.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (686kB) | Preview |
BACKGROUND
Serum albumin concentrations are frequently used to monitor nutritional therapy in the hospital setting but supporting studies are largely lacking. Within this secondary analysis of a randomized nutritional trial (EFFORT), we assessed whether nutritional support affects short-term changes in serum albumin concentrations and whether an increase in albumin concentration has prognostic implications regarding clinical outcome and response to treatment.
METHODS
We analyzed patients with available serum albumin concentrations at baseline and day 7 included in EFFORT, a Swiss-wide multicenter randomized clinical trial that compared individualized nutritional therapy with usual hospital food (control group).
RESULTS
Albumin concentrations increased in 320 of 763 (41.9%) included patients (mean age 73.3 years (SD ± 12.9), 53.6% males) with no difference between patients receiving nutritional support and controls. Compared with patients that showed a decrease in albumin concentrations over 7 days, those with an increase had a lower 180-day mortality [74/320 (23.1%) vs. 158/443 (35.7%); adjusted odds ratio 0.63, 95% CI 0.44 to 0.90; p = 0.012] and a shorter length of hospital stay [11.2 ± 7.3 vs. 8.8 ± 5.6 days, adjusted difference -2.2 days (95%CI -3.1 to -1.2)]. Patients with and without a decrease over 7 days had a similar response to nutritional support.
CONCLUSION
Results from this secondary analysis indicate that nutritional support did not increase short-term concentrations of albumin over 7 days, and changes in albumin did not correlate with response to nutritional interventions. However, an increase in albumin concentrations possibly mirroring resolution of inflammation was associated with better clinical outcomes. Repeated in-hospital albumin measurements in the short-term is, thus, not indicated for monitoring of patients receiving nutritional support but provides prognostic information.
TRAIL REGISTRATION
ClinicalTrials.gov Identifier: NCT02517476.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition |
UniBE Contributor: |
Stanga, Zeno |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1476-5640 |
Publisher: |
Springer Nature |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
10 Jul 2023 12:05 |
Last Modified: |
12 Oct 2023 00:13 |
Publisher DOI: |
10.1038/s41430-023-01303-w |
PubMed ID: |
37419969 |
BORIS DOI: |
10.48350/184606 |
URI: |
https://boris.unibe.ch/id/eprint/184606 |
Actions (login required)
 |
Edit item |