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Zhang PP, Feng HY, Lu DZ, Li TT, Zhang H, Wang XW, Liu WB. Correlation between dysphagia and serum albumin levels and prognosis: a retrospective study. NUTR HOSP 2023; 40:1025-1032. [PMID: 37534474 DOI: 10.20960/nh.04444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
Introduction Introduction: dysphagia is a common complication of stroke, and serum albumin is widely recognized as a strong prognostic marker of health and/or disease status. However, the correlation between dysphagia and serum albumin levels has not been established. Objectives: to observe the correlation between dysphagia and serum albumin levels and prognosis in patients with stroke. Methods: we performed a retrospective study of patients hospitalized between June 1, 2018, and June 1, 2022. A total of 1,370 patients were enrolled. The patients were divided into two groups: dysphagia and non-dysphagia. Binary logistic regression and multiple linear regression models were used to analyze the correlation between dysphagia, albumin, modified Rankin Scale (mRS), activities of daily living (ADL), and length of hospital stay (LOS). Results: after adjusting for confounding factors, the risk of pneumonia in the dysphagia group was 2.417 times higher than that in the non-dysphagia group (OR = 2.417, 95 % CI: 1.902-3.072, p = 0.000). The risk of mRS ≥ 3 and modified Barthel index (MBI) < 60 in patients with dysphagia was 3.272-fold (OR = 3.272, 95 % CI: 2.508-4.269, p < 0.001) and 1.670-fold (OR = 1.670, 95 % CI: 1.230-2.268, p < 0.001), respectively; and the risk of hypoproteinemia was 2.533 times higher (OR = 2.533, 95 % CI: 1.879-3.414, p = 0.000). Stepwise linear regression showed that dysphagia was significantly correlated with lower albumin levels and higher mRS, lower ADL, and longer LOS in patients with stroke (β = -0.220, β = 0.265, β = -0.210, and β = 0.147, respectively; p < 0.001). Conclusions: dysphagia in patients with stroke is associated with decreased albumin levels and has an impact on its prognosis.
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Affiliation(s)
- Ping-Ping Zhang
- Rehabilitation Department. Kunshan Rehabilitation Hospital. Suzhou, School of Rehabilitation Medicine Weifang Medical University
| | - Hai-Yang Feng
- School of Rehabilitation Medicine. Weifang Medical University
| | | | - Ting-Ting Li
- School of Rehabilitation Medicine. Weifang Medical University
| | - Hui Zhang
- School of Rehabilitation Medicine. Weifang Medical University
| | - Xiao-Wen Wang
- School of Rehabilitation Medicine. Weifang Medical University
| | - Wen-Bo Liu
- First Clinical Medical School. Weifang Medical University
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Wang W, Pan CC, Zhao WY, Sheng JY, Wu QQ, Chen SS. Comments on “Effect of type 2 diabetes mellitus in the prognosis of acute-on-chronic liver failure patients in China”. World J Gastroenterol 2022; 28:1499-1502. [PMID: 35582671 PMCID: PMC9048471 DOI: 10.3748/wjg.v28.i14.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/13/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
A study addressing the influence of type 2 diabetes on the prognosis of acute-on-chronic liver failure patients was reviewed. Some statistical deficiencies were found in the reviewed article, and the sample size was too small to support the study. In addition, age should have been considered as one of the prognostic factors.
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Affiliation(s)
- Wei Wang
- Department of Interventional Oncology, Taizhou Municipal Hospital, Taizhou 318000, Zhejiang Province, China
| | - Chen-Chen Pan
- School of Medicine Taizhou University, Taizhou 318000, Zhejiang Province, China
| | - Wen-Ying Zhao
- School of Medicine Taizhou University, Taizhou 318000, Zhejiang Province, China
| | - Jin-Yu Sheng
- School of Medicine Taizhou University, Taizhou 318000, Zhejiang Province, China
| | - Qi-Qi Wu
- School of Medicine Taizhou University, Taizhou 318000, Zhejiang Province, China
| | - Si-Si Chen
- Department of Obstetrics and Gynecology, Taizhou Women and Children’s Hospital of Wenzhou Medical University, Taizhou 318000, Zhejiang Province, China
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Gupta A, Mishra P, Nityanand S. Serum Albumin Predicts Survival in Indian Adult Diffuse Large B cell Lymphoma Patients in the Rituximab Era. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_96_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Objective: The present study was done to evaluate the prognostic impact of the National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) and serum albumin levels in the treatment outcome of Indian diffuse large B-cell lymphoma (DLBCL) patients in the rituximab era. Patients and Methods: We retrospectively analyzed the data (2013–2016) of 135 newly diagnosed DLBCL cases ≥18 years of age. All patients received Rituximab-Cyclophosphamide, Adriamycin, Vincristine, Prednisone (R-CHOP) chemotherapy. The analysis was carried out to assess the overall survival (OS) and progression-free survival (PFS) and the prognostic factors predicting the outcome. Results: Of the 135 patients in the study, 89 (65.9%) had B-symptoms, 20 (14.8%) had bulky disease, 79 (58.5%) had advanced disease (Stage III and IV), and 29 (21.5%) had primary extranodal involvement. Serum albumin ≤3.5 g% was present in 71 (52.6%) patients. About 74 (54.8%) cases were risk stratified to NCCN-IPI high-intermediate-risk group, while 18 (13.3%) patients were categorized into high-risk group. The median PFS and OS of our study cohort were 19 months (95% confidence interval [CI] = 2.59–35.4) and 38 months (95% CI = 9.02–55.68), respectively. Serum albumin ≤3.5 g/dl was significantly associated with poor OS (hazard ratio [HR] = 3.99, 95% CI = 2.25–7.07, P < 0.001) and PFS (HR = 3.71, 95% CI = 2.20–6.26, P < 0.002). Similarly, low NCCN-IPI (<4) was significantly associated with improved OS (HR = 0.21, 95% CI = 0.09–0.47, P < 0.005) and PFS (HR = 0.19, 95% CI = 0.09–0.41, P < 0.001), respectively. These two factors (serum albumin and NCCN-IPI) retained their prognostic significance with respect to OS and PFS in the multivariate analysis. Conclusion: The NCCN-IPI prognostic model and serum albumin levels have independent prognostic significance in Indian DLBCL patients. Serum albumin is a readily available, easy to standardize, and cheap investigation requiring no specialized expertise and holds promise for being incorporated in future DLBCL prognostic risk models.
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Affiliation(s)
- Anshul Gupta
- Departments of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Prabhakar Mishra
- Departments of Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Soniya Nityanand
- Departments of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Mazzaferro EM, Edwards T. Update on Albumin Therapy in Critical Illness. Vet Clin North Am Small Anim Pract 2020; 50:1289-1305. [PMID: 32839002 DOI: 10.1016/j.cvsm.2020.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Albumin is among the most important proteins and plays a significant role in maintenance of colloid osmotic pressure, wound healing, decreasing oxidative damage, carrying drugs and endogenous substances, and coagulation. Hypoalbuminemia is common in acute and chronic illnesses. Replenishment of albumin can be in the form of fresh frozen, frozen or cryopoor plasma, or in the form of human or canine albumin concentrates. Infusion of human albumin concentrate to healthy and critically ill dogs can induce acute and delayed hypersensitivity reactions. Death has been reported. Therefore, allogenic transfusion in the form of plasma products or canine albumin concentrate is recommended.
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Affiliation(s)
- Elisa M Mazzaferro
- Cornell University Veterinary Specialists, 880 Canal Street, Stamford, CT 06902, USA; Emergency and Critical Care, Cornell University Hospital for Animals.
| | - Thomas Edwards
- Research Support Division, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, 3698 Chambers Pass, San Antonio, TX 78234, USA
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Thongprayoon C, Cheungpasitporn W, Chewcharat A, Mao MA, Thirunavukkarasu S, Kashani KB. Impacts of admission serum albumin levels on short-term and long-term mortality in hospitalized patients. QJM 2020; 113:393-398. [PMID: 31747010 DOI: 10.1093/qjmed/hcz305] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/19/2019] [Indexed: 12/14/2022] Open
Abstract
AIM The aim of this study is to assess the association between admission serum albumin and short- and long-term mortality in all hospitalized patients. DESIGN A single-center cohort study. METHODS A retrospective cohort of all adult hospitalized patients at a tertiary referral hospital between January 2009 and December 2013 were analysed. Admission serum albumin was stratified into six groups: ≤2.4, 2.5-2.9, 3.0-3.4, 3.5-3.9, 4.0-4.4 and ≥4.5 g/dl. The outcomes of interest were in-hospital mortality, length of hospital stay and 1-year mortality. Serum albumin of 4-4.4 g/dl was selected as a reference group for outcome comparison. RESULTS A total of 14 075 patients were studied. Admission serum albumin of ≥4.5 g/dl had the lowest in-hospital and 1-year mortality with progressively increased in-hospital mortality observed with decreased admission serum albumin. In adjusted analysis, compared with serum albumin of 4.0-4.4 g/dl, serum albumin of ≤2.4, 2.5-2.9, 3.0-3.4 and 3.5-3.9 were significantly associated with increased in-hospital and 1-year mortality. In contrast, serum albumin of ≥4.5 g/dl was significantly associated with lower 1-year mortality but not in-hospital mortality. Admission serum albumin <4.0 g/dl was significantly associated with a prolonged hospital stay, while admission serum albumin of ≥4.5 g/dl was significantly associated with shorter hospital stay, compared with serum albumin of 4.0-4.4 g/dl. CONCLUSION Low albumin level at admission was progressively associated with increased short- and long-term mortality in all hospitalized patients even when albumin level was considered in normal range.
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Affiliation(s)
- C Thongprayoon
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905
| | - W Cheungpasitporn
- Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216
| | - A Chewcharat
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905
| | - M A Mao
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Jacksonville, FL 32224
| | - S Thirunavukkarasu
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905
| | - K B Kashani
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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Davis A. Current Literature. Nutr Clin Pract 2016. [DOI: 10.1177/088453369701200408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cross-Sectional Guidelines for Therapy with Blood Components and Plasma Derivatives: Chapter 5 Human Albumin - Revised. Transfus Med Hemother 2016; 43:223-32. [PMID: 27403094 PMCID: PMC4924448 DOI: 10.1159/000446043] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/12/2016] [Indexed: 12/21/2022] Open
Abstract
Chapter 5 'Human Albumin' that was suspended on January 10, 2011 has been completed and updated in the present version.
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Park S, Han B, Cho JW, Woo SY, Kim S, Kim SJ, Kim WS. Effect of Nutritional Status on Survival Outcome of Diffuse Large B-Cell Lymphoma Patients Treated with Rituximab-CHOP. Nutr Cancer 2014; 66:225-33. [DOI: 10.1080/01635581.2014.867065] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Esfahani A, Ghoreishi Z, Abedi Miran M, Sanaat Z, Ostadrahimi A, Eivazi Ziaei J, Ghayour Nahand M, Asghari Jafarabadi M, Sorusheh Y, Esmaili H. Nutritional assessment of patients with acute leukemia during induction chemotherapy: association with hospital outcomes. Leuk Lymphoma 2013; 55:1743-50. [DOI: 10.3109/10428194.2013.853766] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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10
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Arrieta O, Michel Ortega RM, Villanueva-Rodríguez G, Serna-Thomé MG, Flores-Estrada D, Diaz-Romero C, Rodríguez CM, Martínez L, Sánchez-Lara K. Association of nutritional status and serum albumin levels with development of toxicity in patients with advanced non-small cell lung cancer treated with paclitaxel-cisplatin chemotherapy: a prospective study. BMC Cancer 2010; 10:50. [PMID: 20170547 PMCID: PMC2843671 DOI: 10.1186/1471-2407-10-50] [Citation(s) in RCA: 194] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Accepted: 02/21/2010] [Indexed: 12/22/2022] Open
Abstract
Background A frequent manifestation of advanced NSCLC is malnutrition, even though there are many studies which relate it with a poor survival, its relation with toxicity has not yet been consistently reported. The aim of this study was to associate malnutrition and albumin serum levels with the occurrence of chemotherapy-induced toxicity in cisplatin plus paclitaxel chemotherapy-treated NSCLC. Methods We prospectively evaluated 100 stage IV NSCLC patients treated with paclitaxel (175 mg/m2) and cisplatin (80 mg/m2). Malnutrition was assessed using SGA prior treatment. Neutrophil Lymphocyte Ratio (NLR) and the Platelet Lymphocyte Ratio (PLR) were used to determine the presence of systemic inflammatory response (SIR) and were related to the development of toxicity. Toxicity was graded according to NCI CTCAE version 3.0 after two chemotherapy cycles. Results Median age was 58 ± 10 years, 51% of patients were malnourished, 50% had albumin ≤3.0 mg/mL. NLR ≥ 5 was associated with basal hypoalbuminemia (mean ranks, 55.7 vs. 39 p = 0.006), ECOG = 2 (47.2 vs. 55.4 p = 0.026) and PLR ≥ 150 were significantly related with a basal body mass index ≤20 (56.6 vs. 43.5; p = 0.02) and hypoalbuminemia (58.9 vs. 41.3; p = 0.02). Main toxicities observed after 2 cycles of chemotherapy were alopecia (84%), nausea (49%), neuropathy (46%), anemia (33%), lymphopenia (31%), and leukopenia (30%). Patients malnourished and with hypoalbuminemia developed more chemotherapy-induced toxicity overall when compared with those without malnutrition (31 vs 22; p = 0.02) and normal albumin (mean ranks, 62 vs 43; p = 0.002), respectively. Hypoalbuminemia was associated with anemia (56 vs 47; p = 0.05), fatigue (58 vs 46; p = 0.01), and appetite loss (57.1 vs 46.7; p = 0.004) compared with normal albumin. PLR ≥ 150 was related with the development of toxicity grade III/IV (59.27 vs. 47.03 p = 0.008) and anemia (37.9 vs 53.8 p = 0.004). Conclusion SIR parameters were associated with malnutrition, weight loss and hypoalbuminemia. Chemotherapy-induced toxicity in NSCLC patients treated with paclitaxel and cisplatin was associated with malnutrition and hypoalbuminemia. Early nutritional assessment and support might confer beneficial effects.
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Affiliation(s)
- Oscar Arrieta
- Medical Oncology Department Instituto Nacional de Cancerología Av San Fernando No 22, Col Sección XVI, Mexico City, 14080 Mexico.
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Martin LG, Luther TY, Alperin DC, Gay JM, Hines SA. Serum antibodies against human albumin in critically ill and healthy dogs. J Am Vet Med Assoc 2008; 232:1004-9. [PMID: 18380616 DOI: 10.2460/javma.232.7.1004] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize the magnitude and duration of the antibody response against human albumin (HA) in critically ill and healthy dogs. DESIGN Cohort and cross-sectional study. ANIMALS Fourteen critically ill dogs that received 25% HA as part of their treatment protocol, 2 healthy dogs with no known previous exposure to HA that received 2 infusions of 25% HA (positive control dogs), and 47 healthy dogs and 21 critically ill dogs with no known exposure to HA (negative control dogs). PROCEDURES An ELISA to detect IgG against HA was developed. Serum samples were obtained from the critically ill dogs prior to infusion of HA, at the time of hospital discharge, and 4 to 6 weeks and 6 months after HA administration. Serum samples were obtained at 2- to 4-week intervals from both positive control dogs for 101 weeks. A single serum sample was obtained from each of the negative control dogs. RESULTS All 14 critically ill dogs developed serum IgG against HA. Peak antibody response was detected 4 to 6 weeks after HA administration. In both positive control dogs, IgG against HA was detected 10 days after HA administration and continued past 97 weeks. The peak antibody response was detected at 3 weeks in 1 dog and at 9 weeks in the other. Five of the 68 (7%) negative control dogs had a positive antibody response. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that dogs developed a pronounced IgG response following exposure to HA and that some dogs with no history of HA administration were positive for anti-HA IgG.
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Affiliation(s)
- Linda G Martin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164-6610, USA
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12
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Abstract
There are relatively few studies of albumin use in neonates and children, with most showing no consistent benefit compared with the use of crystalloid solutions. Certainly, albumin treatment is not indicated for treatment of hypoalbuminemia alone. Studies also show that albumin is not indicated in neonates for the initial treatment of hypotension, respiratory distress, or partial exchange transfusions. In adults, albumin is not considered to be the initial therapy for hypovolemia, burn injury, or nutritional supplementation. Based on the evidence, albumin should be used rarely in the neonatal ICU. Albumin may be indicated in the treatment of hypovolemia only after crystalloid infusion has failed. In patients with acute hemorrhagic shock, albumin may be used with crystalloids when blood products are not available immediately. Inpatients with acute or continuing losses of albumin and normal capillary permeability and lymphatic function, such as during persistent thoracostomy tube or surgical site drainage, albumin supplementation will prevent the development of hypoalbuminemia, and possibly edema formation. This has not been studied systematically, however. In patients with hypoalbuminemia and increased capillary permeability, albumin supplementation often leads to greater albumin leakage across the capillary membrane, contributing to edema formation without improvement in outcome. As the disease process improves and capillary permeability normalizes, albumin supplementation may accelerate recovery, but long-term benefits of albumin treatment usually cannot be demonstrated. These patients will recover whether or not albumin is administered.
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Affiliation(s)
- Michael R Uhing
- Division of Neonatology, Medical College of Wisconsin, Neonatal Intensive Care Unit, Children's Hospital of Wisconsin, Milwaukee, WI 53226, USA.
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Dervenis C, Avgerinos C, Lytras D, Delis S. Benefits and limitations of enteral nutrition in the early postoperative period. Langenbecks Arch Surg 2003; 387:441-9. [PMID: 12607126 DOI: 10.1007/s00423-003-0350-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2002] [Accepted: 12/24/2002] [Indexed: 01/02/2023]
Abstract
BACKGROUND Preexisting malnutrition has been shown to be a major clinical problem in surgical patients. Surgical stress itself increases the energy expenditure and protein loss making necessary the early nutritional support. Although there is strong evidence that "nil by mouth" is not justified, the data are still conflicting over the role of early enteral nutrition compared with the traditional methods of postoperative feeding including total parenteral nutrition support. METHODS AND FOCUS This paper deals with the various trials related to early enteral feeding. It also compares this with the possible advantages of total parenteral nutrition as a method of perioperative nutritional support in patients undergoing gastrointestinal surgery.
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Affiliation(s)
- Christos Dervenis
- 1st Department of Surgery, Agia Olga Hospital, 3-5 Agias Olgas Street, 14233, Athens, Greece.
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Mazzaferro EM, Rudloff E, Kirby R. The role of albumin replacement in the critically ill veterinary patient. J Vet Emerg Crit Care (San Antonio) 2002. [DOI: 10.1046/j.1435-6935.2002.00025.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Braga M, Gianotti L, Gentilini O, Liotta S, Di Carlo V. Feeding the gut early after digestive surgery: results of a nine-year experience. Clin Nutr 2002; 21:59-65. [PMID: 11884014 DOI: 10.1054/clnu.2001.0504] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Early enteral nutrition (EEN) after surgery should be preferred to parenteral feeding, but its clinical use is limited for concerns about possible gastrointestinal (GI) adverse effects and feeding tube-related complications. Thus we evaluated our experience focusing on safety and tolerance of early postoperative jejunal feeding and possible risk factors for gastrointestinal adverse effects. METHODS 650 subjects treated with EEN after major digestive surgery for cancer were prospectively studied. EEN was started within 12 hours after operation via a naso-jejunal (NJ) feeding tube or a catheter-feeding jejunostomy. The rate of infusion was progressively increased to reach the nutritional goal (25 kcal/kg/day) within the 4th postoperative day. Rigorous treatment protocols for diet delivery and EEN-related GI adverse effects were applied. RESULTS 402 patients had a jejunostomy and 248 patients a NJ tube. EEN-related GI adverse effects were observed in 194/650 patients (29.8%). In 136/194 patients, these events were successfully handled by treatment protocols. Overall the nutritional goal was achieved in 592/650 patients (91.1%). Fifty-eight (8.9%) subjects had to be switched to parenteral feeding because of refractory intolerance to EEN. Intra-abdominal surgical complications and low serum albumin (<30 g/L) were the two major factors affecting tolerance. Severe jejunostomy-related complications occurred in 7/402 (1.7%) patients. EEN-related mortality was 0.1% (1/650). CONCLUSIONS The use of the gut early after surgery is safe and well-tolerated and it should represent the first choice for nutritional support in this type of patients.
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Affiliation(s)
- M Braga
- Department of Surgery, San Raffaele University, Milan, Italy
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16
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Chan DL, Freeman LM, Rozanski EA, Rush JE. Colloid Osmotic Pressure of Parenteral Nutrition Components and Intravenous Fluids. J Vet Emerg Crit Care (San Antonio) 2001. [DOI: 10.1111/j.1476-4431.2001.tb00065.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Llop JM, Muñoz C, Badía MB, Virgili N, Tubau M, Ramón JM, Pita A, Jódar JR. Serum albumin as indicator of clinical evolution in patients on parenteral nutrition. Multivariate study. Clin Nutr 2001; 20:77-81. [PMID: 11161547 DOI: 10.1054/clnu.2000.0159] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The aim of this study is to establish whether serum albumin concentration at the beginning of parenteral nutrition is related to morbidity and mortality. METHODS In this cohort study spanning four years, a number of patients were classified into twelve groups, depending on their clinical status at the beginning of parenteral nutrition. Their serum albumin concentration and other clinical parameters were then measured and twelve multiple logistic regression models were thus generated in order to model the relationship between initial albumin concentration and risk of morbidity/mortality. RESULTS 1953 (84%) of the 2321 patients studied were hypoalbuminemic. In six models, this condition was associated with a significant increase in the risk of nosocomial infection. However, no model could be associated to significant risk of renal failure, and only patients with previous hepatopathy were at risk for hepatic failure. In seven models, there was a significant increase in mortality. CONCLUSIONS Serum albumin concentration at the beginning of parenteral nutrition is related to mortality and morbidity associated with nosocomial infection in some groups of the study.
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Affiliation(s)
- J M Llop
- Servicio de Medicina Preventiva, Unidad de Nutrición Parenteral del Servicio de Farmacia, Ciutat Sanitària i Universitària de Bellvitge, Feixa Llarga s/n, E-08907 L'Hospitalet de Llobregat, Spain
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The Use of Serum Albumin as a Prognostic or Nutritional Marker and The Pros and Cons of IV Albumin Therapy. Nutr Clin Pract 1998; 13:110-122. [DOI: 10.1002/j.1941-2452.1998.tb03058.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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