BACKGROUND: Hypoalbuminemic patients admitted to the hospital for community-acquired pneumonia have increased mortality and morbidity. The aim of this study was to investigate the reasons for hypoalbuminemia in these patients. METHODS: During a 12-month period, all patients aged 50 to 85 years (with the exception of immunocompromised patients) with community-acquired pneumonia who were admitted to the Department of Infectious Diseases at Danderyd Hospital, Stockholm, Sweden, were included in a prospective study. The population studied consisted of 97 patients with a mean age of 69.6 years. The patients' nutritional status, including weight, history of weight loss, body mass index, and triceps skinfold thickness, was assessed on admission, as well as at two follow-up visits 8 weeks and 6 months after discharge from the hospital. Blood samples were drawn on admission, during the time in the hospital, and at the follow-up visits. Laboratory tests performed included the following: plasma proteins, albumin, transthyretin and transferrin, alpha 1-antitrypsin, orosomucoid, haptoglobin, C-reactive protein, and interleukin-6. RESULTS: No correlation was found between the serum albumin levels and the nutritional measurements. The serum albumin levels correlated positively with the transthyretin and transferrin levels, and inversely with the acute-phase proteins. CONCLUSIONS: The inflammatory reaction is the main reason for depressed serum albumin levels in elderly patients with pneumonia. The study results do not support the use of nutritional supplementation to alter the clinical outcome in these patients.
BACKGROUND: Hypoalbuminemic patients admitted to the hospital for community-acquired pneumonia have increased mortality and morbidity. The aim of this study was to investigate the reasons for hypoalbuminemia in these patients. METHODS: During a 12-month period, all patients aged 50 to 85 years (with the exception of immunocompromised patients) with community-acquired pneumonia who were admitted to the Department of Infectious Diseases at Danderyd Hospital, Stockholm, Sweden, were included in a prospective study. The population studied consisted of 97 patients with a mean age of 69.6 years. The patients' nutritional status, including weight, history of weight loss, body mass index, and triceps skinfold thickness, was assessed on admission, as well as at two follow-up visits 8 weeks and 6 months after discharge from the hospital. Blood samples were drawn on admission, during the time in the hospital, and at the follow-up visits. Laboratory tests performed included the following: plasma proteins, albumin, transthyretin and transferrin, alpha 1-antitrypsin, orosomucoid, haptoglobin, C-reactive protein, and interleukin-6. RESULTS: No correlation was found between the serum albumin levels and the nutritional measurements. The serum albumin levels correlated positively with the transthyretin and transferrin levels, and inversely with the acute-phase proteins. CONCLUSIONS: The inflammatory reaction is the main reason for depressed serum albumin levels in elderly patients with pneumonia. The study results do not support the use of nutritional supplementation to alter the clinical outcome in these patients.