C-reactive Protein Levels and Decrease of Albumin Levels in Hospitalized Elderly Patients with Community-Acquired Pneumonia  

Oleh:

Harimurti, Kuntjoro ; Setiati, Siti

Jenis: Article from Journal - ilmiah nasional - terakreditasi DIKTI
Dalam koleksi: Acta Medica Indonesiana vol. 39 no. 01 (Jan. 2007), page 13.
Topik: CRp; albumin; community-acquired pneumonia; elderly.

Ketersediaan

Perpustakaan FK Nomor Panggil: A02.K.2004.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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ABSTRACT Aim: to obtain: (I) the correlation between initial CRP level on admission with the decrease of albumin level during hospitalization, (2) the mean difference in initial CRP level between the groups of patients with and without decrease of albulI/in level during hospitalization, and (3) the risk differ¬mce of decrepsing albumin level in patients with high CRP levels all the admission compared to whom with low CRP level 011 the admission, in hospitalized elderly patients with CAP. Methods: a prospective cohort study were conducted on 23 IlOspitali~ed elderly patients with CAP. Subjects with diseases and conditions that could interfere with CRP and albulI/in level besides pneumonia infection were excluded. The patient's CRP level was measured upon the initiation of the study, while the patient's albumin level was measured on the first and fifth day of hospitalization to observe changes that took place during 5 days of hospitalization. Pearson's correlation test, independent t-test, and chi-square test were used to answer the objectives of the study. Results: we found that there were negative correlation between the initial CRP level and the percentage of albumin level decrease during 5 days of hospitalization (r=-0.442, p= 0.035) and significance difference in the mean initial CRP level between patients with and without decreasing albumin level (II/ean difference 99.69 mg/L, 95%CI13.25 to 186.13 IIlg/L; P 0.026). The risk difference of decreasing albumin level during hospitalization between patients with high and low illitial CRP levels did not attaint statistical significance (RR 2.12. 95%Cl 0.26 to 29.07; p=0.621). Conclusion: in hospitalized elderly patients with cOllllllllllity-acquired pneumonia with high initial CRP levels tend to experience a decrease in albumin level during hospitalization INTRODUCTION Community-acquired pneumonia (CAP) is a common health problem in elderly patients. Some study reported as well as epidemiological and clinical data . demonstrate that the incidence, prevalence, and the mortality rate of CAP increase as a person gets 0Ider.1-4 One of the factors that facilitates the development of pneumonia in an elderly person and acts as a negative prognosis factor and predictor of death in persons with pneumonia, is low albumin level.s-8 The role of hypoalbuminemia in causing a bad course of disease is by far more related to malnutrition, which is often found in an elderly.9 However, decreased albumin levels during acute infection is also directly caused by the underlying inflammation process, to some extent, could provide an illustration of the severity of infection/ inflammation.lo-Is Because of this characteristic during acute inflammation, albumin often mentioned as a negative acute-phase protein. 16.17 At the same time the level of C-reactive protein (CRP) elevates, as a positive acute-phase protein that have been recognized and widely studied in various types of acute infection, includes pneumonia.17.zo The relationship between albumin and CRP level in inflammation has been widely investigated, but mostly only in various chronic diseases, i.e. in patients with endstage renal disease (ESRD) undergoing hemodialysisZI-z3 and the elderly population assumed to have various chronic inflammation.z4 In patients with acute infection, especially pneumonia, there has only been one study that observed the correlation between albumin with CRP and other acute inflammatory markers at the beginning of hospitalization in hospitalized CAP patients.8 There have

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