articolo MALNUTRIZIONE CLINICAL CHEMISTRY (original) (raw)
Related papers
Clinical Chemistry, 2006
Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showe...
Assessing Nutritional Status Of Critically Ill Patients Using Serum Prealbumin Levels
Journal of Ayub Medical College, Abbottabad : JAMC, 2019
BACKGROUND Malnutrition in hospitalized patients, contributes to poor outcomes. Biomarker serum prealbumin, can prevent the complications by commencement of nutritional support to improve clinical outcomes. This study was designed to assess the association between low serum prealbumin level (<18 mg/dl), with length of stay and all cause intensive care unit mortality. METHODS This cross-sectional study was conducted from July 2016 to July 2017 at Aga Khan University Hospital Karachi Pakistan. All consecutive patients, aged between 18 to 70 years, admitted in medical or surgical intensive care unit were included. Demographic, clinical history and blood samples for analysing serum prealbumin were obtained on first day of admission. Patients were categorized into two groups based on their serum prealbumin level (taking <18 mg/dl as low). RESULTS A total of 139 patients were included in this study; 95 (68.3%) were male. Median (Q3-Q1) prealbumin level of 12.3 mg/dl (18.8-8.7) was o...
Prealbumin in nutrition evaluation
Nutrition, 1996
We compressed 16 test-pattern classes of albtmnn (ALB), cholesterol (CHOL), and total protein (TPR) in 545 chemistry profiles to 4 classes by converting decision values to a number code to separate malnourished (1 or 2) from nonmahtourished (NM) (0) patients, using as cutoff values for nonmalnourished (0), mild (l), and moderate (2): ALB 35, 27 g/L; TPR 63, 53 g/L, CHOL 3.9, 2.8 mmol/L; and BUN 9.3, 3.6 mmol/L. The BUN was found to have too low an S-value to make a contribution to the compressed classification. The cutoff values for classifying the data were. assigned prior to statistical analysis, after examinin g information in the stmctmed data. The data was obtained by a natural experiment in which the test profiles routinely done by the laboratory were randomly extracted. The analysis identifies the values for the variables used that best classify the data and am not dependent on distributional assumptions. The data were converted to 0, 1, or 2 as outcomes, to create a ternary truth table (each tow is nnnn, the n value is 0 to 2). This allows for 34 (81) possible patterns, without the inclusion of prealbumin (PAB). The emerging system has much fewer patterns in the information-rich truth table formed (a purposeful, far from random, event). We added PAB, cc&d, and examined the data for 129 patients. The classes are a compressed truth table of n-coded patterns with outcomes of 0, 1, or 2 with protein-energy mahmtrition (PEM) increasing from an all-0 to all-2 pattern. Pattern class (F = 154), PAB (F = 35), ALB (F = 56), and CHOL (F = 18) were different across PEM class and predicted PEM class (R* = 0.7864, F = 119, p < Ee5). Km&al-Wallis analysis of class by ranks was significant for pattern class (lE-I*), PAB (6.1E-I'), ALB (1E-16), CHOL (SE-"'), and TPR (5.3EeL3). The medians and standard error
Serumalbumin--a qualified parameter to determine the nutritional status?
Swiss medical weekly, 2006
The primary objective of the study was to evaluate the relationship between serum albumin concentration and nutritional status. As a secondary objective, correlations between nutritional status, the length of hospital stay, the number of drugs taken and patients' age were assessed. In a mono-centre non-interventional trial hospitalised patients were screened for undernutrition. Length of hospital stay, number of drug prescriptions, number of diagnoses, age and serum albumin concentration were recorded. Undernutrition was defined using the criteria of Edington et al. Of 232 screened patients, 102 entered the study, 52 men and 50 women with a mean age of 62.5 (SD+/-19.5) years. Twenty-nine (28.4%) patients were classified as undernourished and 73 as well-nourished. Nineteen of 25 (76%) undernourished patients showed a hypoalbuminaemia (30.5+/-6.5 g/l) compared with 74.5% (44/59) well-nourished patients (32.0+/-5.8 g/l, p 0.093). On average the length of hospital stay in undernouri...
Clinical Nutrition, 2017
Background: The new definition of malnutrition in adults proposed recently by The European Society for Clinical Nutrition and Metabolism (ESPEN) changed the view on the issue and raised the question of the reliability of available diagnostic tools. Therefore, the aim of this study was to verify the accuracy of the two most commonly used screening tools by comparing their findings with the new ESPEN criteria. Methods: Nutritional screening was performed in 1146 (median age 60 years, interquartile range: 44-73 years, 617 males, 529 females) patients on admission to hospitals with two nutritional screening tools: Nutritional Risk Screening 2002 (NRS2002) and Malnutrition Universal Screening Tool (MUST). The screening results were then compared to the ESPEN new diagnostic criteria for malnutrition. Results: According to the NRS2002 13.5% and 27.9% of the outpatients and hospitalized patients respectively were found to be at moderate/high risk of malnutrition. With the use of MUST 9.1% and 14.9% of the outpatients and hospitalized patients respectively were found to be at moderate/high risk of malnutrition. According to the ESPEN diagnostic criteria 6.4% and 11.3% of outpatients and hospitalized patients respectively were classified as malnourished. MUST was found to be better correlated to the latter for both outpatients (K=0.777, p<0.001) and hospitalized patients (K=0.843, p<0.001) as compared to NRS2002 (k=0.256, p<0.001 and k=0.228, p<0.001). ROC plots Area Under the Curve (AUC) was found to be higher for MUST compared to NRS2002 (0.964 vs. 0.695 for outpatients and 0.980 vs 0.686 for hospitalized patients respectively). Conclusion: To our knowledge, this study is the first to analyze the clinical value of a malnutrition screening tool in the light of the new ESPEN definition for malnutrition. According
Clinical Chemistry and Laboratory Medicine 01/2003; 40(12):1360-9
Despite substantial evidence of the crucial role protein calorie malnutrition (PCM) plays in the occurrence of complications, increased length of stay, and cost of care in hospitalized populations, no standard approach for screening and monitoring the nutritional status of patients initially and throughout admission currently exists. Recognizing that there is a growing public and professional recognition of the importance of malnutrition, a large patient population (30-55%) at risk for PCM, and an even larger population experiencing declining nutritional status during hospitalization, this study examined the feasibility of a full-scale study to assess the value of two biochemical markers, transthyretin and albumin, for detecting and monitoring PCM in hospitalized patients. It was demonstrated that these two markers do provide important information predictive of outcomes for those they identify at risk for PCM. The patients who entered the study with or developed low transthyretin and albumin experienced poorer health outcomes and higher costs of care. Their discharge occurred in an early phase of recovery with significant implications for after-discharge care. The full-scale study must consider severity of illness and other confounders during randomization and, preferably, be conducted in institutions that currently do not use transthyretin for nutrition assessment.