TY - JOUR
T1 - The role of visceral protein markers in protein calorie malnutrition
AU - Brugler, Linda
AU - Stankovic, Ana
AU - Bernstein, Larry
AU - Scott, Frederick
AU - O'Sullivan-Maillet, Julie
N1 - Funding Information:
This research was supported by funds provided by the Association of Teachers of Preventive Medicine (ATPM)/Centers for Disease Control and Prevention (CDC) under cooperative agreement U50/CCU300860. We are indebted to Dade Behring, Inc. (Deerfield, Illinois, USA) for providing the equipment, reagents, and technical support required for measuring the visceral proteins. We acknowledge that, proteins without the support and dedication of the RDs, Dawn Clausing, Shoba Kalsey, Marilym Paluba and Tiffany Basso, the nutrition services department; the medical staff; and the administration of SFH this study would not have been possible. We also acknowledge that this study could not have been done without the cooperation and collaboration of the SFH laboratory management and staff, especially the contribution of Susan Wilson who performed all of the study tests. We are grateful to the staff members at the Clinical Laboratory Management Association (CLMA) and to Gary Bickford of Dade Behring, Inc. for their invaluable help in the initial planning and design of the study. We would like to acknowledge the statistical assistance provided by John Hancock of the CDC. Special thanks go to Judy Macêdo, grants coordinator at UMDNJ-School of Health Related Professions for her editorial expertise in the writing of this manuscript. Finally, our gratitude goes to Michael Fitzpatrick for his crucial role in the entrollment of study patients and to Joan Manning and Harry Quinn for their assistance with electronic data retrieval.
PY - 2002
Y1 - 2002
N2 - 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 (30-55%) at risk for PCM, and an even larger population experiencing declining nutritional status during hospitalization, this study examined the feasibility of a full-scale 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 after-discharge care. The full-scale 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.
AB - 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 (30-55%) at risk for PCM, and an even larger population experiencing declining nutritional status during hospitalization, this study examined the feasibility of a full-scale 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 after-discharge care. The full-scale 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.
KW - Albumin
KW - Economic implications
KW - Health care costs
KW - Health outcomes
KW - Nutrition assessment
KW - Prealbumin
KW - Protein calorie malnutrition
KW - Transthyretin
UR - http://www.scopus.com/inward/record.url?scp=0036918571&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036918571&partnerID=8YFLogxK
U2 - 10.1515/CCLM.2002.235
DO - 10.1515/CCLM.2002.235
M3 - Review article
C2 - 12553444
AN - SCOPUS:0036918571
SN - 1434-6621
VL - 40
SP - 1360
EP - 1369
JO - Zeitschrift fur klinische Chemie und klinische Biochemie
JF - Zeitschrift fur klinische Chemie und klinische Biochemie
IS - 12
ER -