Background: Serum prealbumin (PA) levels have been found to have prognostic value in patients with infectious diseases. Objectives: We aimed to determine the relationship between PA levels and clinical outcomes in children with severe Mycoplasma pneumoniae pneumonia (MPP). Methods: We retrospectively reviewed the data of 163 children with severe MPP who were treated in our hospital from January 2015 to December 2017. The demographic and clinical data of the subjects were collected and statistically analyzed. Results: Our cohort was divided into quartiles by PA level. The average D-dimer level, pediatric risk of mortality (PRISM) III score, total length of stay in hospital (TLSH), C-reactive protein/PA ratio, and proportion of patients with invasive intubation significantly decreased as the serum PA level increased. In addition, the PRISM III estimated mortality and the procalcitonin/PA ratio significantly differed among the four PA groups. Binary logistic regression analysis showed that PA level (odds ratio [OR]: 0. 846, 95% confidence interval [CI]: 0. 773-0. 926, P = 0. 000) and invasive intubation (OR: 4. 581, 95% CI: 1. 730-12. 124, P = 0. 002) were independently correlated with PRISM III scores. Multiple linear regression analysis showed that PA level ( =-0. 025, 95% CI:-0. 048 to-0. 002, P = 0. 032) was negatively associated with the normal score of TLSH calculated using the Blom formula. Conclusions: The present study demonstrated that in children with severe MPP, low PA levels correlated with increased PRISM III scores and prolonged TLSH, suggesting that low PA levels contribute to the progression of severe MPP and possibly lead to poor outcomes.
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