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Admission albumin levels and functional outcome of elderly hip fracture patients: is it that important?

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Abstract

Background and aims: Low serum albumin level is considered a marker of poor health outcome in various medical conditions. A relationship between low albumin levels and poor functional outcome has been found in the elderly, lower albumin predicting a greater functional decline. The objective of this study was to evaluate to what extent admission albumin levels may affect the functional outcome of elderly hip fracture patients. Methods: This retrospective chart review study was conducted in an orthogeriatric unit of a university-affiliated referral hospital. The participants were 449 elderly patients with hip fractures, admitted for a standard rehabilitation course. Functional outcome of patients with normo-albuminemia and hypo-albuminemia was assessed by Functional Independence Measurement (FIM™ at admission and discharge. Data were analyzed by t-test, Pearson’s correlation, Chi-square test and Linear Regression. Results: 38.8% of patients were hypoalbuminemic upon admission. These patients were older (p<0.001) and had lower Mini-Mental State Examination (MMSE) scores (p=0.003), compared with normo-albuminemic patients. Discharge FIM scores were higher in normo-albuminemic compared with hypo-albuminemic patients (total FIM 86.1±23.9 and 77.0±26.4, respectively; p<0.001; motor-FIM 60.0±16.3 and 53.4±18.0, respectively; p<0.001). Linear regression analysis showed that total FIM at discharge was inversely associated with pre-fracture function (beta −0.13; p<0.001). A high MMSE score (beta 0.16; p<0.001), female gender (beta 0.05; p=0.02) and higher admission total FIM scores (beta 0.69; p<0.001) emerged as predictors of higher total FIM scores upon discharge. Albumin levels did not independently predict better total FIM scores upon discharge (beta −0.02; p=0.36). Conclusions: Normo-albuminemic patients present with better admission FIM scores and have higher discharge FIM scores. After controlling for possible confounders, albumin remains a non-significant predictor of higher discharge FIM scores. We suggest that low albumin levels should not be considered as adversely affecting the rehabilitation of elderly hip fracture patients.

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Authors and Affiliations

  1. Department of Geriatric Medicine and Rehabilitation, Sheba Medical Center, Tel Hashomer

    Eliyahu H. Mizrahi, Yehudit Fleissig, Marina Arad & Abraham Adunsky

  2. The Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv

    Marina Arad & Abraham Adunsky

  3. The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Tzvia Blumstein

Authors
  1. Eliyahu H. Mizrahi
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  2. Yehudit Fleissig
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  3. Marina Arad
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  4. Tzvia Blumstein
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  5. Abraham Adunsky
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Correspondence to Eliyahu H. Mizrahi.

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Mizrahi, E.H., Fleissig, Y., Arad, M. et al. Admission albumin levels and functional outcome of elderly hip fracture patients: is it that important?. Aging Clin Exp Res 19, 284–289 (2007). https://doi.org/10.1007/BF03324703

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  • DOI: https://doi.org/10.1007/BF03324703

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