The prognostic value of serum albumin levels and respiratory rate for community-acquired pneumonia: A prospective, multi-center study

PLoS One. 2021 Mar 4;16(3):e0248002. doi: 10.1371/journal.pone.0248002. eCollection 2021.

Abstract

Community-acquired pneumonia (CAP) is a respiratory disease frequently requiring hospital admission, and a significant cause of death worldwide. This study aimed to investigate the prognostic value of clinical indicators. A prospective, multi-center study was conducted (January 2017-December 2018) where patient demographic and clinical data were recorded (N = 366). The 30-day mortality rate was 5.46%. Cox Regression analyses showed that serum albumin (ALB) and respiratory rate (RR) were independent prognostic variables for 30-day survival in patients with CAP. Albumin negatively correlated with the Pneumonia Severity Index (PSI) and CURB-65 scores using Pearson and Spearman tests. Survival curves showed that a RR >24 breaths/min or ALB ≤30 g/L were associated with a significantly higher risk of mortality. The area-under-the-curve (AUC) for predicting 30-day mortality in patients with CAP was 0.762, 0.763, 0.790, and 0.784 for ALB, RR, PSI, and CURB-65, respectively. The AUC for the prediction of 30-day mortality using ALB combined with PSI, CURB-65 scores, and RR was 0.822 (95% CI 0.731-0.912), 0.847 (95% CI 0.755-0.938), and 0.847 (95% CI 0.738-0.955), respectively. Albumin and RR were found to be reliable prognostic factors for CAP. This combination showed equal predictive value when compared to adding ALB assessment to PSI and CURB-65 scores, which could improve their prognostic accuracy.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Area Under Curve
  • Community-Acquired Infections / blood*
  • Community-Acquired Infections / diagnosis*
  • Community-Acquired Infections / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Respiratory Rate*
  • Serum Albumin, Human / analysis*
  • Severity of Illness Index

Substances

  • Serum Albumin, Human

Grants and funding

This work was supported by the National Science and Technology Major Project of China (2017ZX10103004-006) and the National Key Research and Development Programme of China (2016YFC0903800). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.