In-Hospital Mortality in Patients Older Than 60 Years with Very Low Albumin Levels

ContextLow albumin levels have been associated with increased mortality, but few studies have looked at the mortality rates of patients with very low albumin levels.ObjectivesThe objective of this study was to determine the in-hospital mortality rates for patients older than 60 years with albumin levels <2.0 g/dL.MethodsThis was a retrospective study of 543 consecutive patients older than the age of 60 who had an albumin level <2.0 g/dL while admitted to Summa Akron City Hospital between July and November 2008. Data were obtained from hospital databases. Mortality rates were calculated for each albumin level and compared with the overall inpatient mortality for patients older than 60 years. Rates of discharge to home were calculated by albumin level. Cross-tabulations and correlations were conducted to determine the association between albumin level and mortality, and to assess the independent effects of total parenteral nutrition, dialysis, cancer, and end-stage renal disease.ResultsPatients with albumin levels between 1.0 and 1.4 had a 41% in-hospital mortality rate, with only 16% of the patients being discharged to home. Patients with albumin levels between 1.5 and 1.9 had a 21% mortality rate, with 33% of patients discharged to home. Overall hospital mortality for patients older than 60 years was 6% during the study period. Total parenteral nutrition, cancer, dialysis, and end-stage renal disease were not independent risk factors for mortality in this study.ConclusionAn albumin level is readily obtained across all areas of the hospital and provides a simple and useful aid in identifying patients at high risk of a poor hospital outcome.