Low transthyretin concentration linked to adverse prognosis in elderly inpatients

Abstract

Objective: To investigate the association between low transthyretin concentration and mortality or readmission for all causes in elderly inpatients. Methods: This was a prospective cohort study conducted from September 2018 to April 2019 in ten wards of three tertiary referral hospitals in Beijing. Patients aged 65 years or older were enrolled, and their clinical data, laboratory test results, and auxiliary test results for patients were collected. A three-year follow-up was conducted with patients. Based on the 5th and 95th percentiles of transthyretin concentration, patients were split into three groups. The correlation between transthyretin concentration and the outcome of elderly hospitalized patients was investigated. The primary outcome of the research was death or readmission from all causes within three years. Results: Of 636 individuals in the study, 335 (52.7%) were males, and the median age (interquartile range [IQR]) was 74.7(69.3,80.1) years. 363 individuals (57.0%) had all-cause death or readmission events during a median follow-up of 1099.00( IQR:1016.25,1135.00) days. Transthyretin concentration at or below the 5th percentile increased the risk of all-cause mortality or readmission than patients with between the 5th to 95th percentiles transthyretin concentration (hazard ratio:2.25; 95% confidence interval:1.55-3.26). The results indicated that elderly inpatients with low transthyretin concentration were at risk of poor outcomes. After adjusting for potential confounding factors, low transthyretin concentration remained an independent risk factor of poor prognosis in elderly inpatients(hazard ratio:1.62; 95% confidence interval:1.01-2.59). Conclusions: Elderly inpatients with low transthyretin concentrations have an increased all-cause mortality or readmission.