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Evaluation of an estimation formula for the biological nutritional status in unexpectedly hospitalized older people

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2022. Ressources en ligne : Abrégé : Introduction. A reliable interpretation of albumin is essential for older adults’ biological nutritional assessment (BNA). However, this can be difficult to achieve because of the high number of influencing factors. The main objective was to evaluate whether a correction formula proposed for prolonged inflammation could be extrapolated to acute biological inflammation situations: corrected albuminemia = measured albuminemia + CRP/25. Method. This prospective, single-center observational study included patients over 65 years of age who were unexpectedly hospitalized in geriatrics and internal medicine at Grenoble Alpes University Hospital, excluding patients with active neoplasia, hepatic insufficiency, or nephrotic syndrome, and patients who still had acute biological inflammation on day 8. A clinical and biological collection was made on day 1 and day 8. The primary endpoint was the comparison of albuminemia corrected by the formula on day 1 with measured albuminemia on day 8. Results. A total of 175 patients were analyzed. The average CRP was 64 (3; 324) mg/L on day 1 and 24 (3; 99) mg/L on day 8. Between corrected albumin on day 1 and albumin on day 8, the correlation was ρ = 0.58, 95% CI [0.47; 0.67], P < 0.001, and the mean difference of 2.9 (-13.5; 18) mg/L, 95% CI [-3.68;-2.20], P < 0.001. Between day 1 albumin and day 8 albumin, the correlation was ρ = 0.74, 95% CI [0.66; 0.80], P < 0.001, and the mean difference of 0.4 (-14; 11) mg/L, 95% CI [-0.24; 1.02], ρ = 0.23. Discussion. The proposed formula cannot be extrapolated to acute inflammatory situations. Measured albuminemia appears to be stable during acute biological inflammation situations. Measured albuminemia could be used as a reference for biological nutritional assessment, as part of a clinical history.
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Introduction. A reliable interpretation of albumin is essential for older adults’ biological nutritional assessment (BNA). However, this can be difficult to achieve because of the high number of influencing factors. The main objective was to evaluate whether a correction formula proposed for prolonged inflammation could be extrapolated to acute biological inflammation situations: corrected albuminemia = measured albuminemia + CRP/25. Method. This prospective, single-center observational study included patients over 65 years of age who were unexpectedly hospitalized in geriatrics and internal medicine at Grenoble Alpes University Hospital, excluding patients with active neoplasia, hepatic insufficiency, or nephrotic syndrome, and patients who still had acute biological inflammation on day 8. A clinical and biological collection was made on day 1 and day 8. The primary endpoint was the comparison of albuminemia corrected by the formula on day 1 with measured albuminemia on day 8. Results. A total of 175 patients were analyzed. The average CRP was 64 (3; 324) mg/L on day 1 and 24 (3; 99) mg/L on day 8. Between corrected albumin on day 1 and albumin on day 8, the correlation was ρ = 0.58, 95% CI [0.47; 0.67], P &lt; 0.001, and the mean difference of 2.9 (-13.5; 18) mg/L, 95% CI [-3.68;-2.20], P &lt; 0.001. Between day 1 albumin and day 8 albumin, the correlation was ρ = 0.74, 95% CI [0.66; 0.80], P &lt; 0.001, and the mean difference of 0.4 (-14; 11) mg/L, 95% CI [-0.24; 1.02], ρ = 0.23. Discussion. The proposed formula cannot be extrapolated to acute inflammatory situations. Measured albuminemia appears to be stable during acute biological inflammation situations. Measured albuminemia could be used as a reference for biological nutritional assessment, as part of a clinical history.

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