The long-term prognostic value of serum 25(OH)D, albumin, and LL-37 levels in acute respiratory diseases among older adults

Abstract

Background Older adults are more susceptible to respiratory tract infection than healthy working age adults. The increased susceptibility of older adults is thought to be interlinked with vitamin D status, nourishment, and immunological state in general. Data are scarce whether these parameters could serve as prognostic markers. Aim To study whether serum 25(OH)D, albumin, and LL-37 level could give prognostic value of long-term survival in the older adults with multimorbidity and acute respiratory infection. Methods Consecutive episodes of hospital care of patients 65 years and older with respiratory symptoms were prospectively studied as a cohort. Standard clinical questionnaire was filled by the study physician. Laboratory markers included serum levels of 25(OH)D, albumin and LL-37, C-reactive protein (CRP), white blood cell count (WBC) and polymerase chain reaction diagnostics for 14 respiratory viruses. Pneumonia was confirmed by chest radiographs. Respiratory illness severity, death at ward, length of hospital stays, and 5-year survival were used as outcomes. Results In total, 289 older adult patients with mean age of 83 years were included in the study. Serum 25(OH)D deficiency (< 50 nmol/liter) was present in 59% and hypoalbuminemia (< 3.5 g/dL) in 55% of the study patients. Low serum albumin level was associated to one, two- and five-year mortality after hospital stay (all P < .05). In addition, it was associated with pneumonia, dyspnea, over 13-night long stay at ward and death at ward (all P < .05). No associations were seen between serum 25(OH)D and LL-37 levels and disease severity, short-term clinical outcome, or long-term survival. Associations between serum 25(OH)D, albumin, and LL-37 levels and respiratory virus presence were not seen. Conclusions Serum albumin level on admission seems to give valuable information about the patients’ general health and recovery potential in treating older adults with respiratory symptoms. Serum 25(OH)D and LL-37 had no associations with disease severity or long- and short-term prognosis among older adults hospitalized with respiratory symptoms.

Serum Albumin as Prognostic Marker for Older Adults in Hospital and Community Settings

“…Their findings demonstrated that patients with higher serum albumin levels had a longer survival rate compared to those with lower levels ( Hu et al, 2023 ). Aronen et al (2022) investigated the association between serum albumin levels and mortality rates among older adults admitted to Turku City Hospital in Finland due to respiratory symptoms. Their study revealed a significant correlation between low serum albumin levels and higher mortality rates, as well as increased risk of pneumonia, dyspnea, and death during hospitalization ( Aronen et al, 2022 ).…”

“… Aronen et al (2022) investigated the association between serum albumin levels and mortality rates among older adults admitted to Turku City Hospital in Finland due to respiratory symptoms. Their study revealed a significant correlation between low serum albumin levels and higher mortality rates, as well as increased risk of pneumonia, dyspnea, and death during hospitalization ( Aronen et al, 2022 ). Similarly, a retrospective cohort study at Boston’s Beth Israel Deaconess Medical Centre in Israel, focusing on patients admitted to the intensive care unit found that patients with lower serum albumin levels had significantly higher ICU and hospital mortalities compared to those with higher levels, highlighting the prognostic value of serum albumin in predicting adverse outcomes in critically ill older adults ( Jin et al, 2022 ).…”

Development and validation of a nomogram for predicting pulmonary complications in elderly patients after thoracic surgery

“…An increase in the leukocyte count may indicate that the body is in a state of stress or in ammation, which will have a series of effects on PPCs. Studies have shown that diseases that cause elevated leukocyte counts before surgery, such as preoperative acute pulmonary infection and sepsis, are independent risk factors for PPCs [17,[23][24][25]. However, the effect of preoperative leukocyte counts elevated but within the normal range on PPCs is complex.…”

C-Reactive Protein and Albumin Levels as Useful Tools for Predicting In-Hospital Outcomes in Polish Nonagenarians

“… 25 Aronen et al also stressed that albumin level on admission appeared to be a predictor of potential patient recovery in treating respiratory infections in older adults. 26 Dagmura et al studied octogenarians and nonagenarians undergoing colorectal cancer surgery and also identified albumin level as a prognostic marker for survival. 11 Similarly, Huang et al observed that serum albumin predicted mortality in a group of nonagenarians with acute infections.…”