January 1992

Serum Albumin Level on Admission as a Predictor of Death, Length of Stay, and Readmission

Author Affiliations

From the Center for Clinical Computing (Drs Herrmann and Safran) and the Division of General Medicine and Primary Care (Dr Safran), Department of Medicine, Harvard Medical School, Beth Israel Hospital, and the Charles A. Dana Research Institute and Harvard Thorndike Laboratory of Beth Israel Hospital, Boston, Mass; the Division on Aging (Drs Levkoff and Minaker) and the Department of Social Medicine and Health Policy (Dr Levkoff), Harvard Medical School, Boston; and the Geriatric Research Education Clinical Center, West Roxbury/Brockton Veterans Affairs Medical Center, Boston (Dr Minaker).

Arch Intern Med. 1992;152(1):125-130. doi:10.1001/archinte.1992.00400130135017

We studied the serum albumin level within 48 hours of hospitalization for acute illness to predict in-hospital death, length of stay, and readmission in 15 511 patients older than 40 years. Patients with low serum albumin levels (<34 g/L), who made up 21% of the population, were more likely to die, had longer hospital stays, and were readmitted sooner and more frequently than patients with normal albumin levels. The in-hospital mortality was 14% among patients with low albumin levels, as compared with 4% among patients with normal levels. Although the serum albumin level was a nonspecific marker, it was a stronger predictor of death, length of stay, and readmission than age. We conclude that the serum albumin level on admission is an important variable that should be incorporated in severityof-illness measures based on physiologic indexes.

(Arch Intern Med. 1992;152:125-130)