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Article

Serum Albumin Is Independently Associated with Length of Hospital-Stay and Short-Term Mortality in Elderly Heart Failure Patients: A Real-World Experience

by
Gianluigi Cuomo
1,2,*,
Paolo Tirelli
2,
Gabriella Oliva
2,
Domenico Birra
2,
Antonietta De Sena
2,
Fabio Granato Corigliano
2,
Mariavittoria Guerra
2,
Claudio De Luca
2,
Benedetta Tartaglia
2,
Vittoria Gammaldi
2,
Carmine Fierarossa
2,
Pasquale Madonna
2,
Vincenzo Nuzzo
2 and
Francesco Giallauria
1
1
Department of Translational Medical Sciences, “Federico II” University of Naples, Via S. Pansini 5, 80131 Naples, Italy
2
Department of General Medicine, “Ospedale del Mare”, ASL Napoli 1 Centro, 80147 Naples, Italy
*
Author to whom correspondence should be addressed.
Hearts 2025, 6(4), 34; https://doi.org/10.3390/hearts6040034
Submission received: 21 November 2025 / Revised: 14 December 2025 / Accepted: 17 December 2025 / Published: 18 December 2025
(This article belongs to the Collection Feature Papers from Hearts Editorial Board Members)
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Abstract

Background: Serum albumin is a well-known marker of nutritional and inflammatory status and has been associated with adverse outcomes in heart failure (HF). However, its predictive value for length of hospital-stay and short-term mortality in elderly HF patients remains underexplored. Objectives: To investigate the association between serum albumin levels at hospital admission and length of stay, as well as post-admission mortality, in a cohort of elderly patients hospitalized for HF. Methods: We conducted a retrospective analysis of 56 consecutive patients aged ≥65 years admitted for HF. Comorbidities were assessed using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G), and inflammatory status was measured via C-reactive protein (CRP). Negative binomial regression with robust confidence intervals was employed to evaluate the relationship between serum albumin and length of hospital-stay, adjusting for age, comorbidity burden, and CRP. Cox proportional hazards models were used to assess mortality at 6 months and 1 year, adjusting for age, comorbidity, CRP, and HF subtype, with Kaplan–Meier curves illustrating unadjusted survival differences according to albumin levels and HF subtype. Results: Mean age was 78.6 ± 7.5 years, with 69.6% female patients. Mean serum albumin at admission was 3.58 ± 0.60 g/dL, and mean length of stay was 14.8 ± 10.1 days. Each 1 g/dL increase in albumin was associated with a 32% reduction in length of stay (adjusted IRR = 0.68; 95% CI: 0.54–0.85; p = 0.01), independently by age, inflammatory status and comorbidity. Serum albumin was independently associated with reduced risk of death at 6 months (HR 0.30; 95% CI: 0.11–0.82; p = 0.019) and 1 year (HR = 0.41; 95% CI: 0.17–0.96; p = 0.041). Conclusions: Serum albumin at hospital admission independently predicts length of stay and short-term mortality in elderly patients with HF. Albumin measurement, simple, cheap and universally available biomarker, is helpful for early risk stratification and may guide clinical management in this vulnerable population.
Keywords: mortality; heart failure; elderly; albumin; length of stay mortality; heart failure; elderly; albumin; length of stay
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MDPI and ACS Style

Cuomo, G.; Tirelli, P.; Oliva, G.; Birra, D.; Sena, A.D.; Corigliano, F.G.; Guerra, M.; De Luca, C.; Tartaglia, B.; Gammaldi, V.; et al. Serum Albumin Is Independently Associated with Length of Hospital-Stay and Short-Term Mortality in Elderly Heart Failure Patients: A Real-World Experience. Hearts 2025, 6, 34. https://doi.org/10.3390/hearts6040034

AMA Style

Cuomo G, Tirelli P, Oliva G, Birra D, Sena AD, Corigliano FG, Guerra M, De Luca C, Tartaglia B, Gammaldi V, et al. Serum Albumin Is Independently Associated with Length of Hospital-Stay and Short-Term Mortality in Elderly Heart Failure Patients: A Real-World Experience. Hearts. 2025; 6(4):34. https://doi.org/10.3390/hearts6040034

Chicago/Turabian Style

Cuomo, Gianluigi, Paolo Tirelli, Gabriella Oliva, Domenico Birra, Antonietta De Sena, Fabio Granato Corigliano, Mariavittoria Guerra, Claudio De Luca, Benedetta Tartaglia, Vittoria Gammaldi, and et al. 2025. "Serum Albumin Is Independently Associated with Length of Hospital-Stay and Short-Term Mortality in Elderly Heart Failure Patients: A Real-World Experience" Hearts 6, no. 4: 34. https://doi.org/10.3390/hearts6040034

APA Style

Cuomo, G., Tirelli, P., Oliva, G., Birra, D., Sena, A. D., Corigliano, F. G., Guerra, M., De Luca, C., Tartaglia, B., Gammaldi, V., Fierarossa, C., Madonna, P., Nuzzo, V., & Giallauria, F. (2025). Serum Albumin Is Independently Associated with Length of Hospital-Stay and Short-Term Mortality in Elderly Heart Failure Patients: A Real-World Experience. Hearts, 6(4), 34. https://doi.org/10.3390/hearts6040034

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