Turkish Journal of Geriatrics 2026 , Vol 29, Issue 1
INFLAMMATORY AND NUTRITIONAL BIOMARKERS FOR PREDICTING MORTALITY IN ELDERLY PATIENTS WITH COMMUNITY- ACQUIRED PNEUMONIA
Gülhan AYHAN ALBAYRAK1, Mustafa İlteriş BARDAKÇI1
1Şişli Hamidiye Etfal Training and Research Hospital , Chest diseases, İstanbul, Türkiye DOI : 10.29400/tjgeri.2026.475 Introduction: Community-acquired pneumonia remains a leading cause of morbidity and mortality among older adults. Although conventional scoring systems, such as CURB-65 and pneumonia severity indexes, provide prognostic guidance, novel inflammation- and nutrition-based biomarkers may offer enhanced predictive accuracy. This study evaluated and compared the prognostic performance of six novel biomarkers; neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, prognostic nutritional index, lymphocyteto- monocyte ratio, C-reactive protein-to-albumin ratio, and modified Glasgow prognostic score in comparison with conventional scoring systems in elderly patients hospitalized with community-acquired pneumonia.

Materials and Method: A total of 105 patients aged ?65 years who were hospitalized with community-acquired pneumonia between 2020 and 2025 were included in this retrospective cohort study, and their clinical, laboratory, and demographic data were collected. Prognostic performance for 30-day mortality was assessed using receiver-operating characteristic curves, Area Under the Receiver Operating Characteristic Curve and Kaplan?Meier survival analyses.

Results: C-reactive protein-to-albumin ratio demonstrated the highest discriminatory ability, followed by prognostic nutritional index and neutrophilto- lymhocyte ratio. Although elevated platelet lymphocyte ratio was associated with reduced survival rates (p=0.038), none of the novel biomarkers remained independent predictors in multivariate Cox regression analyses.

Conclusion: C-reactive protein-to-albumin ratio is a simple, cost-effective, and highly predictive biomarker for in-hospital mortality in elderly patients with community-acquired pneumonia, outperforming other indices and complementing conventional scores. Estimation of C-reactive protein-toalbumin ratio may facilitate early risk stratification and guide interventions in this population. Keywords : Community-Acquired Pneumonia; Inflammation Mediators; Biomarkers; Prognosis; Aged