Risk factors that influence the prognosis of community-acquired pneumonia in hospitalized adults

Objective The present study assessed the influence of nutritional parameters on the prognosis of community-acquired pneumonia in adults admitted to a general hospital. Methods A total of 61 individuals with community-acquired pneumonia were studied prospectively and the following data analyzed: sociodemographic variables, morbidity, life habits, anthropometric variables (body mass index, waist circumference, percentage of body fat, percentage of weight lost), biochemical variables (urea, creatinine, albumin on admission and 18 days later, prealbumin on admission and 4, 8 and 18 days later), and outcome (hospital stay shorter than 10 days, longer than 10 days and/or death). Results Anthropometric variables differed between genders but were not associated with poor outcome. Albumin and prealbumin levels were low on admission in 80.3% and 86.9% of the cases, respectively. Logistic regression showed that smoking (OR: 1.23; CI: 1.0-12.1), more than one finding or pleural effusion on chest radiographs (OR: 1.4; CI: 1.24-15.3) and low prealbumin on day 4 (OR: 6.1; CI: 1.7-22.5) predicted a poor outcome for patients with community-acquired pneumonia. Conclusion Nutrition-related biochemical markers, such as low prealbumin, smoking and more than one finding on chest radiographs, indicate severe pneumonia and are useful for deciding treatment strategy.