Admission serum albumin concentrations and response to nutritional therapy in hospitalised patients at malnutrition risk: Secondary analysis of a randomised clinical trial.
Admission serum albumin concentrations and response to nutritional therapy in hospitalised patients at malnutrition risk: Secondary analysis of a randomised clinical trial.
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DOI：
10.1016/j.eclinm.2022.101301
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发表时间：
2022-03
影响因子：
15.1
通讯作者：
Schuetz P
中科院分区：
文献类型：
--
作者：
Bretschera C;Boesiger F;Kaegi-Braun N;Hersberger L;Lobo DN;Evans DC;Tribolet P;Gomes F;Hoess C;Pavlicek V;Bilz S;Sigrist S;Brändle M;Henzen C;Thomann R;Rutishauser J;Aujesky D;Rodondi N;Donzé J;Stanga Z;Mueller B;Schuetz P
从历史上看，入院血清白蛋白浓度被认为是营养评估的有用生化标志物。然而，缺乏随机试验数据来调查低白蛋白浓度是否有助于识别从营养支持中受益的患者。本研究是对 EFFORT 试验的二次分析，该试验是一项瑞士范围内的多中心随机对照试验，比较了 2014 年 4 月 1 日至 2018 年 2 月 1 日住院患者的个体化营养支持与常规护理营养。纳入了 2028 名入院时具有可用白蛋白浓度的营养风险患者中的 1389 名患者。主要终点是 30 和 180 天内的全因死亡率。根据 30 g/L 的白蛋白临界值，将患者分为低白蛋白组或正常白蛋白组。 ClinicalTrials.gov 编号，NCT02517476。纳入 1389 名患者（平均年龄 73.1 (SD 3.5) 岁；747 名 (53.8%) 男性），其中 676 名 (48.7%) 患者入院时血清白蛋白浓度较低 (<30 g/L)。与白蛋白浓度正常的患者相比，低白蛋白组的 180 天死亡率显着增加（219/676 (32.4%) vs. 162/713 (22.7%)，完全调整 HR 1.4，95%CI 1.11 至 1.77，p = 0.005]。与白蛋白浓度正常的患者相比，营养支持对 30 天死亡率的影响相似白蛋白浓度（HR 0.68，95%CI 0.44 至 1.05 对比 HR 0.70，95%CI 0.41 至 1.20），没有证据表明存在亚组效应（交互作用 p = 0.97）。根据这项随机试验的二次分析，住院、非危重、处于营养风险的内科患者的低入院血清白蛋白浓度具有预后意义并表明死亡风险较高，但瑞士国家科学基金会 (SNSF) (PP00P3_150531) 和阿劳州医院研究委员会 (1410.000.058 和 1410.000.044) 为 EFFORT 试验提供了资金。
Historically, admission serum albumin concentrations have been considered useful biochemical markers for nutrition assessment. However, there is a lack of randomised trial data investigating whether low albumin concentrations are helpful for identifying patients benefitting from nutritional support. This study was a secondary analysis of the EFFORT trial, a Swiss-wide multicentre, randomised controlled trial comparing individualised nutritional support with usual care nutrition in medical inpatients from April 1, 2014, to February 1, 2018. 1389 of 2028 patients at nutritional risk with available albumin concentrations on admission were included. The primary endpoint was all-cause mortality within 30 and 180 days. Patients were stratified into groups of low or normal albumin based on the albumin cut-off of 30 g/L. ClinicalTrials.gov number, NCT02517476. 1389 patients (mean age, 73.1 (SD 3.5) years; 747 (53.8%) men) were included and 676 (48.7%) had low serum albumin concentrations at admission (<30 g/L). Mortality at 180 days was significantly increased in the low albumin group compared with patients with normal albumin concentrations (219/676 (32.4%) vs. 162/713 (22.7%), fully adjusted HR 1.4, 95%CI 1.11 to 1.77, p = 0.005]. Effects of nutritional support on 30-day mortality were similar for patients with low compared to patients with normal albumin concentrations (HR 0.68, 95%CI 0.44 to 1.05 vs. HR 0.70, 95%CI 0.41 to 1.20), with no evidence for a subgroup effect (p for interaction=0.97). Based on this secondary analysis of a randomised trial, low admission serum albumin concentrations in hospitalised, non-critically ill, medical patients at nutritional risk had prognostic implications and indicated higher mortality risk but were not helpful in selecting patients for nutritional interventions. The Swiss National Science Foundation (SNSF) (PP00P3_150531) and the Research Council of the Kantonsspital Aarau (1410.000.058 and 1410.000.044) provided funding for the EFFORT trial
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DOI：
10.12659/msm.894238
发表时间：
2015-10-02
期刊：
Medical science monitor : international medical journal of experimental and clinical research
影响因子：
--
作者：
Konturek PC;Herrmann HJ;Schink K;Neurath MF;Zopf Y
通讯作者：
Zopf Y
DOI：
10.1177/014860717700100111
发表时间：
1977-01-01
期刊：
JPEN. Journal of parenteral and enteral nutrition
影响因子：
--
作者：
Blackburn, G L;Bistrian, B R;Smith, M F
通讯作者：
Smith, M F
影响因子：
3.1
作者：
Evans, David C.;Corkins, Mark R.;Jensen, Gordon L.
通讯作者：
Jensen, Gordon L.
影响因子：
4.4
作者：
Baumgartner, Annic;Pachnis, Daphne;Schuetz, Philipp
通讯作者：
Schuetz, Philipp
影响因子：
6.3
作者：
Gomes, Filomena;Schuetz, Philipp;Bischoff, Stephan C.
通讯作者：
Bischoff, Stephan C.