Abstract: Objective To explore the correlation between dynamic change pattern of prealbumin (PA) and 28-day prognosis in elderly patients with severe community-acquired pneumonia (SCAP). Methods A total of 80 elderly patients with SCAP admitted to Xuanwu Hospital Capital Medical University from January 2024 to January 2025 were enrolled. The patients were divided into survival group and death group based on 28-day outcomes. The level of PA on the first day, fourth day and seventh day of admission were compared between the two groups. According to the type of PA change, the patients were divided into the group with initial rise and then decline, the group with continuous decrease and the group with other types, and the survival curves of the three groups were compared. Results On the first and fourth day of hospitalization, there was no statistically significant differenct in PA levels betwwen the survial group and death group (P＞0.05); On the seventh day, the level of PA in the survival group (140.0±59.1 mg/L) was significantly higher than that in the death group (107.9±51.6 mg/L) (P<0.05). There was a significant difference in the distribution of PA change patterns between the two groups (P<0.05). Median survival time was highest in the group with other types, followed by the group with initial rise and then decline and the group with continuous decrease (P<0.001). Conclusions Dynamic PA change patterns is associated with 28-day mortality in the elderly patients with SCAP.

Key words: aged, severe community-acquired pneumonia, prealbumin, prognosis