SHORT-TERM 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) TI 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 IT score and a high TSF were both associated with readmission within 6 months of discharge. The alfa-l-antitrypsin concentration was the most closely correlated with duration of fever. We conclude that the admission concentrations of alfa-l-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.