Prevalence and significance of hypoalbuminemia in an internal medicine department

Background: Serum albumin is commonly measured in hospitalized patients. It has habitually been included among the parameters used for nutritional assessment, and recently its use has become even more widespread. Yet, no data are available in the literature about the prevalence and clinical significance of hypoalbuminemia in patients hospitalized in an internal medicine ward. The aim of this study was to investigate the prevalence and clinical significance of hypoalbuminemia in in-hospital internal medicine patients. Methods: We retrospectively evaluated the albumin level of patients admitted to the Department of Internal Medicine and Biomedical Sciences of the University of Parma during the year 2000. We then evaluated sex, age, nutritional status, some laboratory parameters, associated diseases, and length of hospitalization in hypoalbuminemic patients in comparison with a group of patients without hypoalbuminemia. Results: Hypoalbuminemics (46.5% of patients) were older, more frequently anemic, and had a higher erythrocyte sedimentation rate (ESR) and longer hospitalization; they were mostly normal weight or overweight. These patients also had chronic liver (18.6% vs. 4.5%), oncohematological (33.8% vs. 12%), and infectious diseases (13.4% vs. 2.3%) and nephropathies (6.3% vs. 2%) more often than patients without hypoalbuminemia. The presence of onco-hematological diseases was related to anemia (O.R.=5.73; 95% CI: 3.184-10.310), lymphopenia (O.R.=2.76; 95% CI: 1.584-4.801), and hypoalbuminemia (O.R.=2.5; 95% CI: 1.178-5.307). Conclusions: Hypoalbuminemia is very frequent in an internal medicine ward. In this setting, serum albumin is related to the length of hospitalization and to other parameters with a well-known prognostic value (age, hemoglobin) and clinical usefulness (ESR). It may also play a role in the evaluation of the possible association of onco-hematological diseases. (C) 2008 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.