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Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia.


J Infect. 2012 Dec 31;


Authors: Viasus D, Garcia-Vidal C, Simonetti A, Manresa F, Dorca J, Gudiol F, CarratalĂ  J


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.

PMID: 23286966 [PubMed - as supplied by publisher]