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The independent association between plasma and red blood cell zinc levels with long-term outcomes of hospitalized patients

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Background — Plasma and red blood cell (RBC) zinc values are unrelated in hospitalized patients. The independent association of these values with important patient outcomes is unknown.

Methods — Plasma and RBC zinc were prospectively measured within 48 hours of hospitalization in consenting patients. Data were linked deterministically with population-based health administrative data to measure each zinc measures’ association with two outcomes (time to death from any cause, likelihood of death or urgent readmission to hospital within 30-days of discharge) after adjusting for validated outcome risk scores.

Results — 250 people admitted to medical services were studied. Patients were ill with a 1-year baseline expected death risk [interquartile range] of 19.9% [6.3-37.2]. Observed 1- and 2-year all-cause death risk was 24.5% (95%CI 19.6-30.3) and 33.2% (27.3-39.9), respectively. Death risk increased significantly as plasma zinc levels decreased (p=0.0001). This association persisted even after adjusting for baseline expected death risk (p=0.02) with every 2 μmol/L decrease in plasma zinc being independently associated with, on average, a 35% increase in death risk. RBC zinc was not associated with death risk. Neither plasma nor RBC zinc levels were significantly associated with 30-day death or urgent readmission.

Conclusions — Plasma, but not RBC, zinc levels are independently associated with all-cause death risk in hospitalized medical patients. Further study is required to determine whether this association is causal and identify its potential causal pathways.

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Citation

Rodic S, McCudden C, van Walraven C. Curr Dev Nutr. 2023; Mar 2 [Epub ahead of print].

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