Short- and long-term prognosis for middle-aged and elderly patients hospitalized with community-acquired pneumonia: impact of nutritional and inflammatory factors.
To investigate the impact of nutritional and inflammatory factors on short- and long-term prognosis for patients hospitalized for community-acquired pneumonia (CAP), 97 patients, 50-85 years old, admitted to the Department of Infectious Diseases at Danderyd Hospital were enrolled in a prospective study. 13 enrolment variables were examined for association with 6 outcome variables. Serum orosomucoid concentration, acute physiology and chronic health evaluation (APACHE) II score, body mass index (BMI) and triceps skinfold (TSF) were each associated with duration of hospital stay. A low TSF and BMI, and a high APACHE II score were all associated with death. A high APACHE II score and a high TSF were both associated with readmission within 6 months of discharge. The alfa-1-antitrypsin concentration was the most closely correlated with duration of fever. We conclude that the admission concentrations of alfa-1-antitrypsin and orosomucoid are better predictors of hospital morbidity than the more commonly used albumin and C-reactive protein (CRP) levels. Measurement of APACHE II and TSF on admission may give additional prognostic information on the interval from admission to 6 months after discharge.
Hedlund
J
J
Department of Infectious Diseases, Karolinska Institutet, Danderyd Hospital, Sweden.
Hansson
L O
LO
Ortqvist
A
A
D018806:APACHE; D000209:Acute-Phase Proteins; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D017714:Community-Acquired Infections / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009747:Nutritional Physiological Phenomena; D009961:Orosomucoid / Q000032:analysis; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D011014:Pneumonia / Q000382:microbiology / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012885:Skinfold Thickness; D015996:Survival Rate; D000515:alpha 1-Antitrypsin / Q000032:analysis
D000209:Acute-Phase Proteins; D009961:Orosomucoid; D012709:Serum Albumin; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein