Nutritional indices may have prognostic value in elderly critically ill patients with sepsis

Authors : Ömür İLBAN

Pages : 145-151

Doi:10.32322/jhsm.1217406

View : 47 | Download : 14

Publication Date : 2023-01-12

Article Type : Research Paper

Abstract :Aim: Nutritional indicators are associated with adverse outcomes in critically ill elderly patients. In this study, we aimed to evaluate the prognostic potential of prealbumin and albumin in the prediction of mortality in elderly patients with sepsis. Material and Method: A total of 108 patients who developed intensive care unit-acquired sepsis were divided into two groups: Survivors insert ignore into journalissuearticles values(n=72); and Non-survivors insert ignore into journalissuearticles values(n=36);. Results: Patients in the Non-survivors group were often older insert ignore into journalissuearticles values(68 vs 74); and presented lower prealbumin insert ignore into journalissuearticles values(15.1 vs 11);, and higher Charlson index insert ignore into journalissuearticles values(4 vs 6);, Sequential Organ Failure Assessment insert ignore into journalissuearticles values(SOFA); score insert ignore into journalissuearticles values(8.5 vs 10);, C-reactive protein insert ignore into journalissuearticles values(CRP); insert ignore into journalissuearticles values(68.8 vs 91); and procalcitonin insert ignore into journalissuearticles values(PCT); insert ignore into journalissuearticles values(6 vs 8.4); insert ignore into journalissuearticles values(p< 0.05);. The area under the curve of PCT was the highest at 0.74. Prealbumin presented the best sensitivity insert ignore into journalissuearticles values(75%); and 12 mg/dL cut-off value, while PCT had the best specificity insert ignore into journalissuearticles values(75%); and a cut-off value of 7 ng/mL. Although prealbumin was negatively correlated to SOFA score in a significant way insert ignore into journalissuearticles values(r=-0.226, p=0.019);, White blood cells, CRP, and PCT were positively correlated to SOFA score insert ignore into journalissuearticles values(r=0.198, p=0.040; r=0.233, p=0.015; r=0.286, p=0.003, respectively);. In addition, a weak negative correlation was observed between prealbumin and CRP and PCT insert ignore into journalissuearticles values(r=-0.203, p=0.037; r=-0.215, p=0.026, respectively);. Multivariate analysis showed that a reduction in serum prealbumin levels compared to steady prealbumin greater than 4 mg/dL increased the risk of death by 85% insert ignore into journalissuearticles values(aHR: 1.85, 95% CI: 1.05-2.56, p=0.029);. Conclusion: Changes in serum prealbumin in the acute phase of sepsis may assist in determining the risk of mortality and in the administration of specific treatment in critically ill elderly patients. 
Keywords : Elderly, inflammation, mortality, prealbumin, sepsis

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