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Serum Albumin Predicts Survival and Postoperative Course Following Surgery for Geriatric Hip Fracture.

Abstract Serum albumin level is the most well-established serum marker of malnutrition, with a serum albumin concentration <3.5 g/dL considered to be suggestive of malnutrition. The purpose of this study was to test if serum albumin level is associated with death, specific postoperative complications (e.g., pneumonia), length of hospital stay, and readmission following a surgical procedure for geriatric hip fracture.
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Journal Title the journal of bone and joint surgery. american volume
Publication Year Start




PMID- 29257017
OWN - NLM
STAT- In-Process
LR  - 20171219
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 99
IP  - 24
DP  - 2017 Dec 20
TI  - Serum Albumin Predicts Survival and Postoperative Course Following Surgery for
      Geriatric Hip Fracture.
PG  - 2110-2118
LID - 10.2106/JBJS.16.01620 [doi]
AB  - BACKGROUND: Serum albumin level is the most well-established serum marker of
      malnutrition, with a serum albumin concentration &lt;3.5 g/dL considered to be
      suggestive of malnutrition. The purpose of this study was to test if serum
      albumin level is associated with death, specific postoperative complications
      (e.g., pneumonia), length of hospital stay, and readmission following a surgical 
      procedure for geriatric hip fracture. METHODS: A retrospective cohort study of
      geriatric patients (&gt;/=65 years of age) undergoing a hip fracture surgical
      procedure as part of the American College of Surgeons National Surgical Quality
      Improvement Program was conducted. Outcomes were compared between patients with
      and without hypoalbuminemia. All comparisons were adjusted for baseline and
      procedural differences between populations, and patients with missing serum
      albumin concentration were included in analyses using a missing data indicator.
      RESULTS: There were 29,377 geriatric patients undergoing a hip fracture surgical 
      procedure who met inclusion criteria; of these patients, 17,651 (60.1%) had serum
      albumin available for analysis. The prevalence of hypoalbuminemia was 45.9%.
      Following adjustment for baseline and procedural characteristics, the risk of
      death was inversely associated with serum albumin concentration as a continuous
      variable (adjusted relative risk, 0.59 [95% confidence interval (CI), 0.53 to
      0.65]; p &lt; 0.001). In comparison with patients with normal albumin concentration,
      patients with hypoalbuminemia had higher rates of death (9.94% compared with
      5.53% [adjusted relative risk, 1.52 (95% CI, 1.37 to 1.70); p &lt; 0.001]), sepsis
      (1.19% compared with 0.53% [adjusted relative risk, 1.92 (95% CI, 1.36 to 2.72); 
      p &lt; 0.001]), and unplanned intubation (2.64% compared with 1.47% [adjusted
      relative risk, 1.51 (95% CI, 1.21 to 1.88); p &lt; 0.001]). The mean length of stay 
      (and standard deviation) was longer among patients with hypoalbuminemia at 5.67
      +/- 4.68 days compared with those without hypoalbuminemia at 4.99 +/- 3.95 days; 
      the adjusted difference was 0.50 day (95% CI, 0.38 to 0.63 day; p &lt; 0.001).
      However, the rate of readmission did not differ (p = 0.054) between patients with
      hypoalbuminemia (10.91%) and those without hypoalbuminemia (9.03%); the adjusted 
      relative risk was 1.10 (95% CI, 1.00 to 1.21). CONCLUSIONS: Hypoalbuminemia is a 
      powerful independent risk factor for mortality following a surgical procedure for
      geriatric hip fracture. These data suggest that further investigation into
      postoperative nutritional supplementation is warranted to decrease the risk of
      complications. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for
      Authors for a complete description of levels of evidence.
FAU - Bohl, Daniel D
AU  - Bohl DD
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago,
      Illinois.
FAU - Shen, Mary R
AU  - Shen MR
AD  - University of North Carolina School of Medicine, Chapel Hill, North Carolina.
FAU - Hannon, Charles P
AU  - Hannon CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago,
      Illinois.
FAU - Fillingham, Yale A
AU  - Fillingham YA
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago,
      Illinois.
FAU - Darrith, Brian
AU  - Darrith B
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago,
      Illinois.
FAU - Della Valle, Craig J
AU  - Della Valle CJ
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago,
      Illinois.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
EDAT- 2017/12/20 06:00
MHDA- 2017/12/20 06:00
CRDT- 2017/12/20 06:00
PHST- 2017/12/20 06:00 [entrez]
PHST- 2017/12/20 06:00 [pubmed]
PHST- 2017/12/20 06:00 [medline]
AID - 10.2106/JBJS.16.01620 [doi]
AID - 00004623-201712200-00008 [pii]
PST - ppublish
SO  - J Bone Joint Surg Am. 2017 Dec 20;99(24):2110-2118. doi: 10.2106/JBJS.16.01620.