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

Introduction. A reliable interpretation of albumin is essential for the elderly's biological nutritional assessment (BNA), but is complex because many parameters change it. The main objective was to evaluate the extrapolation of a correction formula proposed for prolonged inflammation to acute biological inflammation situations: corrected albuminemia = measured albuminemia + CRP/25. Method. This prospective, single-center observation study included patients over 65 years of age who were unexpectedly hospitalized in geriatrics and internal medicine at Grenoble University Hospital, excluding carriers of active neoplasia, hepatic insufficiency, nephrotic syndrome, and those for whom a ABI persisted on the eighth day. A clinical and biological collection was made on the first and eighth days. The primary endpoint was the comparison of albuminemia corrected by the formula on day 1 with measured albuminemia on day 8. Results. One hundred and seventyfive 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 at day 1 and albumin at day 8, the correlation was rho = 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 D1 albumin and D8 albumin, the correlation was rho = 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], P = 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 BNA, integrated into a clinical history.