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. 2022 Jun;13(3):623-632.
doi: 10.1007/s41999-022-00625-5. Epub 2022 Mar 2.

Albumin and C-reactive protein relate to functional and body composition parameters in patients admitted to geriatric rehabilitation after acute hospitalization: findings from the RESORT cohort

Jeanine M Van Ancum  1 , Camilla S L Tuttle  2 , René Koopman  3 , Mirjam Pijnappels  1 , Carel G M Meskers  1   4 , Sanjoy K Paul  5 , Wen Kwang Lim  2 , Esmee M Reijnierse  2   4 , Gordon S Lynch  3 , Andrea B Maier  6   7   8   9
Affiliations

Albumin and C-reactive protein relate to functional and body composition parameters in patients admitted to geriatric rehabilitation after acute hospitalization: findings from the RESORT cohort

Jeanine M Van Ancum et al. Eur Geriatr Med. 2022 Jun.

Abstract

Purpose: Albumin and C-reactive protein (CRP) are non-specific markers of inflammation, which could affect muscle tissue during acute hospitalization. We investigated the association between albumin and CRP during acute hospitalization with functional and body composition parameters in patients admitted to geriatric rehabilitation.

Methods: The REStORing Health of Acutely Unwell AdulTs (RESORT) cohort includes geriatric rehabilitation patients assessed for change in activities of daily living (ADL, using the Katz index) during acute hospitalization, and subsequently for Katz ADL, gait speed (GS), handgrip strength (HGS) and skeletal muscle mass index (SMI) at geriatric rehabilitation admission. Albumin and CRP average (median), variation (interquartile range), and maximum or minimum were collected from serum samples, and were examined for their association with functional and body composition parameters using multivariable linear regression analysis adjusted for age, sex and length of acute hospital stay.

Results: 1769 Inpatients were included for analyses (mean age 82.6 years ± 8.1, 56% female). Median length of acute hospitalization was 7 [IQR 4, 13] days and median number of albumin and CRP measurements was 5 [IQR 3, 12] times. ADL declined in 89% of patients (median - 3 points, IQR - 4, - 2). Lower average albumin, higher albumin variation and lower minimum albumin were associated with larger declines in ADL and with lower ADL, GS, HGS and SMI at geriatric rehabilitation admission. Higher average and maximum CRP were associated with lower GS.

Conclusion: Inflammation, especially lower albumin concentrations, during acute hospitalization is associated with lower physical function at geriatric rehabilitation admission.

Keywords: Activities of daily living; Inflammation; Muscle strength; Physical functional performance; Sarcopenia.

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Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Flowchart of data availability of RESORT
Fig. 2
Fig. 2
Overview of albumin, C-reactive protein and functional and body composition parameters during acute hospitalization and at geriatric rehabilitation admission. ADL activities of daily living, GS gait speed, HGS handgrip strength, SMI skeletal muscle mass index. Dashed lines indicate the average of albumin and C-reactive protein concentrations. Dashed arrows indicate the variation of albumin and C-reactive protein concentrations
Fig. 3
Fig. 3
Clusters of minimum albumin and average CRP during acute hospitalization associated with change in ADL, ADL, GS, HGS and SMI at geriatric rehabilitation admission. ADL activities of daily living, CRP C-reactive protein, GS gait speed, HGS handgrip strength, SMI skeletal muscle mass index. Bars: unstandardized predicted medians adjusted for age, sex and length of acute hospital stay. Change in ADL additionally adjusted for baseline ADL 2 weeks before acute hospitalization. Error bars: upper interquartile range. Low minimum albumin < 29 g/L, high average CRP ≥ 32.4 mg/L
See this image and copyright information in PMC

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