Correlation between serum transferrin level and prognosis in patients receiving total parenteral nutrition.

Background: Transferrin is a useful index of visceral protein, but it is unknown whether changes in the level of transferrin can be used as a prognostic marker for patients receiving nutrition support.

Methods: Consecutive in one-year period, we recorded the data of 325 patients who with unusable gastrointestinal tract received total parenteral nutrition (TPN) for more than 2 weeks. The data included the levels of serum transferrin, albumin, total bilirubin, hemoglobin and white blood cell before and after 2-week nutrition support. Age, sex, body weight, diagnosis, and hospital outcome were also recorded. A total of 305 patients with complete initial data and 221 patients with data on TPN-induced level change were enrolled and evaluated statistically.

Results: The mortality rate was 47.6% in the group of patients who showed no increase of serum transferrin after 2 weeks of TPN. Univariate analysis revealed that the initial level and TPN-induced changes of serum transferrin, albumin and total bilirubin were significantly correlated with patient survival. However, multivariate analysis showed that the initial level of transferrin, albumin, total bilirubin and the TPN-induced level changes in transferrin were independent factors significantly correlated with patient survival. Two of the most the significant factors among them were initial level of transferrin (p < 0.0001, odds ratio = 2.4838) and change in serum transferrin level after 2 weeks of TPN (p < 0.0001, odds ratio = 2.664).

Conclusions: Changes in serum transferrin level in patients with intestinal failure who received TPN for 2 weeks appear to be a good indicator of patient outcome.