Hypoalbuminemia at admission is associated with increased incidence of in-hospital complications in geriatric trauma patients

-Elderly patients are at higher risk of developing protein–energy malnutrition (PEM).-Prospective study evaluating the association between low serum albumin levels at the time of ED admission as a marker of PEM and incidence of in-hospital complications in geriatric trauma patients.-Serum albumin levels at ED admission are a significant independent predictor of in-hospital complications especially, of infectious complications in geriatric trauma patients.-Pre-albumin levels at ED admission have no prognostic value in geriatric trauma patients.

BackgroundElderly 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.MethodsThis 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.ResultsA 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).ConclusionSerum albumin level at ED admission, but not prealbumin level, is a significant predictor of in-hospital complications in geriatric trauma patients.