Short- and long-term prognosis for middle-aged and elderly patients hospitalized with community-acquired pneumonia: impact of nutritional and inflammatory factors

Scand J Infect Dis. 1995;27(1):32-7. doi: 10.3109/00365549509018970.


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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins*
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / mortality
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nutritional Physiological Phenomena*
  • Orosomucoid / analysis
  • Pneumococcal Infections / diagnosis
  • Pneumococcal Infections / microbiology
  • Pneumococcal Infections / mortality
  • Pneumonia / microbiology
  • Pneumonia / mortality*
  • Prognosis
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Serum Albumin / analysis
  • Skinfold Thickness
  • Survival Rate
  • alpha 1-Antitrypsin / analysis


  • Acute-Phase Proteins
  • Orosomucoid
  • Serum Albumin
  • alpha 1-Antitrypsin
  • C-Reactive Protein