Pre-albumin as a marker for predicting weight loss in hospitalised children

ABSTRACT

Objectives: This study sought to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children.Design: A hospital-based longitudinal survey was carried out between December 2013 and February 2014.Setting: Aga Khan University Hospital, Nairobi, Kenya, a tertiary care hospital.Subjects: A total of 170children aged 29 days to 15 years who met the inclusion criteria were included in the study.Outcome measures: Serum prealbumin levels and weight were measured at admission and repeated after 48­96 h. Sensitivity,specificity, and positive and negative predictive values were calculated to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children.Results: Of the 170 children studied, 57% and 60% had a drop in serum pre-albumin level and weight within the first four days of hospitalisation respectively. A drop in pre-albumin occurred in 68% of the 103 patients who had weight loss (p < 0.001).Using a serum pre-albumin cut off point of < 0.15 g/l at admission, sensitivity and specificity of serum pre-albumin in predicting weight loss were 76.7% and 29.0% (negative predictive value = 42.9%; positive predictive value = 64.2%). Positive and negative likelihood ratios were low at 1.08 and 0.8. The majority of the patients (72.3%) were already at risk of malnutrition as determined by the pre-albumin risk stratification on admission.Conclusion: Serum pre-albumin is not an accurate surrogate for weight loss during hospitalisation.It is, however, useful in identifying patients at risk of malnutrition on admission and during hospitalisation