Factors associated with zinc levels in hospitalized patients: An observational study using routinely collected data.
Hospital
Imputation
Prediction
Prognosis
Regression
Zinc
Journal
Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS)
ISSN: 1878-3252
Titre abrégé: J Trace Elem Med Biol
Pays: Germany
ID NLM: 9508274
Informations de publication
Date de publication:
05 May 2020
05 May 2020
Historique:
received:
03
03
2020
revised:
16
04
2020
accepted:
27
04
2020
pubmed:
6
6
2020
medline:
6
6
2020
entrez:
6
6
2020
Statut:
aheadofprint
Résumé
Zinc deficiency is easily treated and has been associated with worse outcomes in hospitalized patients. Zinc testing is time-consuming and relatively costly. We identified every zinc level measured at our teaching hospital and quantified how much zinc variation is explained by other hospital factors. We linked tables from our hospital data warehouse from 1996 to 2019 to identify all patients who had at least 1 serum zinc measured during their admission. We determined the status of factors that could influence zinc levels including severity of illness, presence of bleeding or inflammation, and factors influencing zinc absorption. We identified only 318 adult patients having zinc measurement during their hospitalization. Patients were elderly (median age 71 [IQR 56-78]) and arrived by ambulance 45% of the time. Zinc was measured a median of 5 days into the hospitalization (IQR 3-13) with 154 (51.6%) recording a low level. Almost half of patients were missing at least one covariable laboratory test. Multilinear regression models using complete case analysis returned more extreme parameter estimate values and deemed as significant only two thirds of the factors identified as significant in models using data with missing values imputed. Imputed models found significant associations between lower zinc levels and recent surgery, decreased albumin, creatinine, and sodium, earlier hospitalization day of sampling, and increased patient comorbidity. These models explained 32% of zinc variation. Zinc testing is rare, low zinc levels are very common, and one third of its variation in hospitalized patients is explained by other covariables.
Sections du résumé
BACKGROUND
BACKGROUND
Zinc deficiency is easily treated and has been associated with worse outcomes in hospitalized patients. Zinc testing is time-consuming and relatively costly. We identified every zinc level measured at our teaching hospital and quantified how much zinc variation is explained by other hospital factors.
METHODS
METHODS
We linked tables from our hospital data warehouse from 1996 to 2019 to identify all patients who had at least 1 serum zinc measured during their admission. We determined the status of factors that could influence zinc levels including severity of illness, presence of bleeding or inflammation, and factors influencing zinc absorption.
RESULTS
RESULTS
We identified only 318 adult patients having zinc measurement during their hospitalization. Patients were elderly (median age 71 [IQR 56-78]) and arrived by ambulance 45% of the time. Zinc was measured a median of 5 days into the hospitalization (IQR 3-13) with 154 (51.6%) recording a low level. Almost half of patients were missing at least one covariable laboratory test. Multilinear regression models using complete case analysis returned more extreme parameter estimate values and deemed as significant only two thirds of the factors identified as significant in models using data with missing values imputed. Imputed models found significant associations between lower zinc levels and recent surgery, decreased albumin, creatinine, and sodium, earlier hospitalization day of sampling, and increased patient comorbidity. These models explained 32% of zinc variation.
CONCLUSIONS
CONCLUSIONS
Zinc testing is rare, low zinc levels are very common, and one third of its variation in hospitalized patients is explained by other covariables.
Identifiants
pubmed: 32502791
pii: S0946-672X(20)30105-X
doi: 10.1016/j.jtemb.2020.126540
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
126540Informations de copyright
Copyright © 2020 Elsevier GmbH. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None of the authors have any conflicts of interest regarding this paper.