title: Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia.
abstract: OBJECTIVE
  To investigate whether serum albumin levels within 24 h of admission correlate with outcomes in community-acquired pneumonia (CAP).
  
  
  METHODS
  Observational analysis of a prospective cohort of adults with CAP requiring hospitalization from 1995 through 2011. Serum albumin level was the independent variable. The primary end point was 30-day mortality.
  
  
  RESULTS
  During the study period, 3463 patients with CAP required hospitalization. The median value of albumin was 31 g/L (IQR 28-35). As levels of serum albumin decrease, the risk of complications significantly increases (P < .001). Decreased albumin levels were also associated with prolonged time to reach clinical stability (P < .001), prolonged hospital stay (P < .001), ICU admission (P < .001), the need for mechanical ventilation (P < .001), and 30-day mortality (P < .001). After adjusting for potential confounders in a multivariate logistic regression analysis, serum albumin levels at admission (-5 g/L decrease) were independently associated with a higher risk of 30-day mortality (OR 2.11, 95% CI 1.73-2.56). For predicting primary end point, hypoalbuminemia (<30 g/L) significantly increased the area under ROC curves of PSI and CURB-65 scores (P ≤ .02), and identified those patients with higher risk of complications classified into low- and high-risk groups by these scores.
  
  
  CONCLUSIONS
  Serum albumin level within 24 h of admission is a good prognostic marker in CAP. Physicians should consider albumin level when evaluating the severity of illness in patients with CAP.
authors.affiliation: Department of Infectious Diseases, Hospital Universitari de Bellvitge - IDIBELL, Feixa Llarga s/n, 08907 Barcelona, Spain. dfviasusp@unal.edu.co
authors.forename: Diego
authors.initials: D
authors.lastname: Viasus
authors.forename: Carolina
authors.initials: C
authors.lastname: Garcia-Vidal
authors.forename: Antonella
authors.initials: A
authors.lastname: Simonetti
authors.forename: Frederic
authors.initials: F
authors.lastname: Manresa
authors.forename: Jordi
authors.initials: J
authors.lastname: Dorca
authors.forename: Francesc
authors.initials: F
authors.lastname: Gudiol
authors.forename: Jordi
authors.initials: J
authors.lastname: Carratalà
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood* / Q000175:diagnosis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin