The role of visceral protein markers in protein calorie malnutrition

被引:34
作者
Brugler, L
Stankovic, A
Bernstein, L
Scott, F
O'Sullivan-Maillet, J
机构
[1] St Francis Hosp, Dept Clin Effectiveness, Wilmington, DE 19805 USA
[2] Ctr Dis Control & Prevent, Div Lab Syst, Publ Hlth Practice Program Off, Atlanta, GA USA
[3] New York Methodist Hosp, Brooklyn, NY USA
[4] Int Sci Commun Inc, Shelton, CT USA
[5] Univ Med & Dent New Jersey, Sch Hlth Related Profess, Newark, NJ 07103 USA
关键词
protein calorie malnutrition; transthyretin; prealbumin; albumin; nutrition assessment; health outcomes; health care costs; economic implications;
D O I
10.1515/CCLM.2002.235
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
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 (3055%) at risk for PCM, and an even larger population experiencing declining nutritional status during hospitalization, this study examined the feasibility of a fullscale 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 afterdischarge care. The fullscale 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.
引用
收藏
页码:1360 / 1369
页数:10
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