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 s hort- and long-term prognosis for patients hospitalized for community- acquired pneumonia (CAP), 97 patients, 50-85 years old, admitted to th e Department of Infectious Diseases at Danderyd Hospital were enrolled in a prospective study. 13 enrolment variables were examined for asso ciation with 6 outcome variables. Serum orosomucoid concentration, acu te physiology and chronic health evaluation (APACHE) TI score, body ma ss index (BMI) and triceps skinfold (TSF) were each associated with du ration 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. T he alfa-l-antitrypsin concentration was the most closely correlated wi th 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 ad ditional prognostic information on the interval from admission to 6 mo nths after discharge.