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ISOLATED EXTERNAL JUGULAR VEIN THROMBOSIS IN OLDER PEOPLE

Patients were excluded if their medical diagnoses included a disease state known to disrupt albumin equilibrium. The data was gathered from three sources: patient interview, medical charts, and study-coordinator assessment. The dependent variable was the albumin level in the serum. The explanatory variables were: age, sex, origin, education, occupation, employment status, support and living arrangement, level of communication, dependency status, patient's subjective assessment of change in food consumption and weight, and two measures of burden of disease: existence of chronic disease and severity of disease. For classification of the severity of the disease into five risk categories, we chose the Health Care Financing Administration Model for Classification of the Diagnosis List (ICD 9 CM) by 30-day posthospitalization mortality rates." All patients were classified individually according to the most severe diagnosis on their lists. We used multivariate analysis to identify variables correlated with albumin level in serum. The following variables were significantly independently correlated with a low level of albumin in serum in the multivariate analysis: dependency status bedridden; main supporter support not required; level of social communication partial, absent. (Table 1). Because the bedridden state may be a marker of severity of disease more powerful than the model of severity based on diagnoses only, another multivariate analysis was run that excluded bedridden patients. This analysis resulted in a further model that included only two variables: support level and communication level. Again, none of the burden of disease variables entered this model. Our findings may suggest that hypoalbuminemia is associated with poor parameters of low accessibility to food, such as a high level of dependency, low level of communication, and low level of support. In our study there is no support for the hypothesis that a low level of albumin in serum is an index of the burden of underlying disease. This is an observational study that used mainly indirect parameters to assess food consumption over long periods. Our results, supported by those of others,4.5 indicated the need for further studies aimed at assessing interventions (such as dietary supplement) to raise serum albumin and to determine whether any putative adverse effects of low-levelalbumin can be avoided.