Albumina sérica é preditor independente de mortalidade hospitalar em pacientes com câncer

Abstract

Introduction and goal: Cancer is one of the leading causes of morbidity and mortality worldwide. The identification of prognostic factors is of extreme importance for the definition of treatment and adequate follow-up. Studies have shown a relationship between albumin and the Prognosis Nutritional Index (PNI) of worse survival, even in cancer patients, little is known about the relation of albumin or PNI with in-hospital mortality and length of hospital stay. Moreover, few have adjusted the models with other predictors of mortality from the perspective of a conceptual model. The objective of this study was to verify the potential prediction of albumin and PNI in in-hospital mortality in cancer patients.

Methods:

A retrospective study was conducted between January 2014 and December 2016 with 262 cancer patients at Hospital de Clínicas. Demographic data, blood counts, C-reactive protein (CRP), albumin and hematimetric indexes, nutritional diagnoses and hospital outcomes (discharge or death) were collected. Univariate and multivariate analyzes were performed using the Cox proportional hazards model and also the cumulative probability of death by the kaplan-Meier curves.

Results:

The frequency of death among the study patients was 10.7% (28). Among the patients who died 99.2% (26) presented some degree of moderate or severe malnutrition (p = 0.004). In the multivariate analysis, serum albumin (<3 g / dL) was independently associated with in-hospital mortality (HR 3.43 95% CI 1.11-10.63 p = 0.032). On the other hand, PNI was not associated with in-hospital mortality.

Conclusion:

Serum albumin levels during hospitalization were predictors of in-hospital mortality in the evaluated population. Our results suggest that the serum levels of this protein can be used in clinical practice, adding prognostic information in patients with cancer.