Department of Geriatrics, Turku University Hospital, Turku, Finland.
, Uikunkuja 7, N28100, Pori, Finland.
BMC Geriatr. 2022 Feb 21;22(1):146. doi: 10.1186/s12877-022-02836-8.
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.
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.
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.
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.
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.
老年人比健康的成年劳动者更容易感染呼吸道疾病。老年人的易感性增加被认为与维生素 D 状态、营养和一般免疫状态有关。关于这些参数是否可以作为预后标志物的数据还很缺乏。
研究血清 25(OH)D、白蛋白和 LL-37 水平是否可以为患有多种合并症和急性呼吸道感染的老年人的长期生存提供预后价值。
前瞻性研究了有呼吸道症状的 65 岁及以上患者的连续住院病例作为队列。研究医生填写了标准的临床问卷。实验室标志物包括血清 25(OH)D、白蛋白和 LL-37 水平、C 反应蛋白 (CRP)、白细胞计数 (WBC) 和 14 种呼吸道病毒的聚合酶链反应诊断。胸部 X 光片证实肺炎。呼吸疾病严重程度、病房死亡、住院时间长短和 5 年生存率作为结果。
共纳入 289 名平均年龄为 83 岁的老年患者。59%的患者存在血清 25(OH)D 缺乏症（<50nmol/L），55%的患者存在低白蛋白血症（<3.5g/dL）。低血清白蛋白水平与住院后 1、2 和 5 年的死亡率相关（均 P<0.05）。此外，它还与肺炎、呼吸困难、在病房的逗留时间超过 13 晚和病房死亡相关（均 P<0.05）。血清 25(OH)D 和 LL-37 水平与疾病严重程度、短期临床结局或长期生存无相关性。血清 25(OH)D、白蛋白和 LL-37 水平与呼吸道病毒存在之间无相关性。
入院时的血清白蛋白水平似乎可以为治疗有呼吸道症状的老年人提供有关患者整体健康状况和康复潜力的有价值的信息。血清 25(OH)D 和 LL-37 与住院的有呼吸道症状的老年人的疾病严重程度或长短期预后均无相关性。
