Usefulness of serum albumin concentration for in-hospital risk stratification in frail, elderly patients with acute heart failure. Insights from a prospective, monocenter study.

The present study examined the usefulness of serum albumin concentration measured immediately after clinical stabilization for in-hospital risk stratification in 64 consecutive elderly, institutionalized patients with definite evidence of acute heart failure, of whom 17 died during their in-hospital stay. Serum albumin concentration was a powerful predictor of in-hospital death in this clinical setting (hazard ratio of 0.80 [0.71-0.89], p<0.001). A serum albumin concentration of <3 g/dl (median value) had a sensitivity of 94% and a specificity of 68% for the prediction of in-hospital mortality. Furthermore, this biomarker was able to provide incremental prognostic information over usual prognostic variables obtained at presentation such as age, systolic blood pressure and blood urea nitrogen.