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Keywords:

  • transferrin saturation;
  • National Health and Nutrition Examination Survey;
  • Medicare;
  • mortality

Objectives

To evaluate in a large, nationally representative cohort the association between high serum transferrin saturation (TS) and hospital length of stay and mortality in older adults.

Design

Prospective cohort.

Setting

Longitudinal analyses of the Third National Health and Nutrition Examination Survey linked to Medicare claims from 1991 through 2006.

Participants

Medicare beneficiaries aged 65 and older at baseline.

Measurements

Transferrin saturation collected on each participant at baseline was characterized as <20.0%, 20.0% to 54.9%, and 55.0% and greater. Length of stay in the hospital and death in the hospital were primary outcomes. Analyses were adjusted for age, sex, race and ethnicity, education, and severity of illness.

Results

Individuals hospitalized during the study period (79.4%) with high (odds ratio (OR) = 2.54, 95% confidence interval (CI) = 1.05–6.12) or low (OR = 1.31, 95% CI = 1.07–1.62) TS had a significantly greater risk of death than those with moderate TS. Individuals with high TS had longer average length of stay per hospitalization (11.1 days, (standard error, SE 1.7 days), P = .01) than those with moderate TS (8.4 (0.3) days). Individuals with high TS also had more hospital days per year (8.6 (2.0) days, P = .04) than those with moderate TS (6.7 (0.5) days).

Conclusion

High TS is associated with longer length of stay and death in the hospital (unweighted N = 3,847, weighted N = 28,395,464).