Use of Plasma Prealbumin concentration in assessment of nutritional status of adult patients admitted in rural Hospitals in Rivers State, Nigeria

Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems are now available, PEM is still poorly recognized especially in the rural settings as there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. We studied PEM prevalence and PAB serum concentrations in 120 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). According to the DNA reference method, 51% of patients were classified with mild malnutrition and 23% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 80%) and a good sensitivity/specificity profile (84.9%/78.9%) compared with SGA and PINI. We conclude that PAB could represent a feasible and reliable tool in the evaluation of nutritionalstatus, especially in rural settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.