Is plasma albumin concentration useful in the assessment of nutritional status of hospital patients?

Anthropometric measurements (body weight, height, triceps skinfold thickness and mid-arm circumference measurements) and plasma albumin concentrations were obtained from 546 (308 medical, 238 surgical) general hospital patients. In a subgroup (n = 50) receiving nutritional support, the relationship between nitrogen balance and change in plasma albumin concentration was followed over a minimum period of 2 weeks. Results showed that there was no association between albumin concentration and body weight expressed as percentage of ideal, nor was there an association between albumin concentrations and triceps skinfold thicknesses. However, low albumin concentrations were associated with low mid-arm muscle circumferences and triceps skinfold thicknesses were positively associated with body weight measurements. Patients admitted with low albumin concentrations had the highest mortality rates. In the patients receiving nutritional support, there was no association between improvement in nitrogen balance and increase in albumin concentrations. Furthermore, reductions in albumin concentrations were associated with higher mortality rates. It is concluded that plasma albumin concentrations provide little useful nutritional information in sick patients. They provide a better index of degree of sickness and risk of mortality.