Association between prealbumin, all‐cause mortality, and response to nutrition treatment in patients at nutrition risk: Secondary analysis of a randomized controlled trial
Open accessAbstract
Background Because of the shorter half-life as compared with albumin, serum prealbumin concentrations have been proposed to be useful nutrition biomarkers for the assessment of patients at nutrition risk. In a post hoc analysis of patients at nutrition risk from a randomized controlled nutrition trial, we tested the hypothesis that (1) prealbumin is associated with higher all-cause 180-day mortality rates and that (2) individualized nutrition support compared with usual-care nutrition more effectively improves survival at 30 days in patients with low prealbumin levels compared with patients with normal prealbumin levels. Methods We performed a prespecified cohort study in patients included in the pragmatic, Swiss, multicenter randomized controlled EFFORT trial comparing the effects of individualized nutrition support with usual care. We studied low prealbumin concentrations ( Results A total of 306 (59.2%) patients (mean age 71.9 years, 53.6% men) had low admission prealbumin levels ( Conclusion Among medical inpatients at nutrition risk, low admission prealbumin levels correlated with different nutrition markers and higher mortality risk, but patients with low or high prealbumin levels had a similar benefit from nutrition support. Further studies should identify nutrition markers that help further personalize nutrition interventions.
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Albumin and prealbumin levels have a strong prognostic value but little correlation with nutritional response.
“Albumin and prealbumin levels also have a strong prognostic value, but little correlation with nutritional response [192,193] (both Level of evidence 1þþ).”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [193]
Cites
Schuetz, P., Fehr, R., Baechli, V., Geiser, M., Deiss, M., Gomes, F., Kutz, A., Tribolet, P., Bregenzer, T., Braun, N., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32776-4 · Cited by 910 · see citing works
Self-citationProtein and energy supplementation in elderly people at risk from malnutrition
Milne, A. C., Potter, J., Vivanti, A., & Avenell, A. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003288.pub3 · Cited by 849 · see citing works
The use of visceral proteins as nutrition markers: an ASPEN position paper
Evans, D. C., Corkins, M. R., Malone, A., Miller, S., Mogensen, K. M., Guenter, P., Jensen, G. L., & the ASPEN Malnutrition Committee (2021) · Nutrition in Clinical Practice · doi:10.1002/ncp.10588 · Cited by 589 · see citing works
Self-citationDeutz, N. E., Matheson, E. M., Matarese, L. E., Luo, M., Baggs, G. E., Nelson, J. L., Hegazi, R. A., Tappenden, K. A., & Ziegler, T. R. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2015.12.010 · Cited by 472 · see citing works
ESPEN guidelines on nutritional support for polymorbid internal medicine patients
Gomes, F., Schuetz, P., Bounoure, L., Austin, P., Ballesteros-Pomar, M., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., Poulia, K.-A., et al. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2017.06.025 · Cited by 363 · see citing works
Self-citationMerker, M., Felder, M., Gueissaz, L., Bolliger, R., Tribolet, P., Kägi-Braun, N., Gomes, F., Hoess, C., Pavlicek, V., Bilz, S., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.0663 · Cited by 262 · see citing works
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ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“Al-bumin and prealbumin levels also have a strong prognostic value, but little correlation with nutritional response [192,193] (both Level of evidence 1 þþ ) .”
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- Authors
- Bretscher, C., Buergin, M., Gurzeler, G., Kägi‐Braun, N., Gressies, C., Tribolet, P., Lobo, D. N., Evans, D. C., Stanga, Z., Mueller, B., Schuetz, P., & for the EFFORT study team
- Affiliations
- University of Basel (CH)
- Medical University Department, Division of General Internal and Emergency Medicine Kantonsspital Aarau Aarau Switzerland
- Bern University of Applied Sciences (CH)
- Nottingham University Hospitals NHS Trust (GB)
- Grant Medical Center (US)
- University of Bern (CH)
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2023-01-27
- Volume
- 47
- Issue
- 3
- Pages
- 408-419
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W4313379919
- Cited by
- 44
- References
- 6
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 15 · 2023: 11
- FWCI
- 7.72
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (acceptedVersion, other-oa)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- ARBOR - Bern University of Applied Sciences Repository (submittedVersion)
- BORIS (University Library Bern) (submittedVersion, cc-by)
- BFH: ARBOR
- Open Access CRIS of the University of Bern
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- prealbumin, nutritional risk, all-cause mortality, dietary biomarkers, nutritional risk screening, mortality prediction, hospitalized patients, enteral nutrition
- MeSH terms
- Aged, Female, Humans, Male, Nutritional Status, Prealbumin, Prognosis, Cohort Studies, Biomarkers
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