Prognostic significance of malnutrition for long-term mortality in community-acquired pneumonia: a propensity score matched analysis

• Published in: The Korean journal of internal medicine 2019, 34(4), , pp.841-849
• Main Authors: Yeo, Hye Ju, Byun, Ki Sup, Han, Junhee, Kim, June Hyun, Lee, Seung Eun, Yoon, Seong Hoon, Jeon, Doosoo, Kim, Yun Seong, Cho, Woo Hyun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Community-Acquired Infections - diagnosis; Community-Acquired Infections - mortality; Community-Acquired Infections - therapy; Comorbidity; Female; functional status; Hospital Mortality; Humans; Male; malnutrition; Malnutrition - diagnosis; Malnutrition - mortality; Malnutrition - physiopathology; Malnutrition - therapy; Middle Aged; Nutritional Status; Original; pneumonia; Pneumonia - diagnosis; Pneumonia - mortality; Pneumonia - therapy; Prevalence; Prognosis; Propensity Score; Republic of Korea - epidemiology; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; 내과학
• ISSN: 1226-3303; 2005-6648; 2005-6648
• DOI: 10.3904/kjim.2018.037

The impact of malnutrition on the outcome of hospitalized adults with community-acquired pneumonia (CAP) has not been fully investigated. This study evaluated the prevalence and prognostic significance of malnutrition in a Korean population with CAP. In total, 198 patients with CAP from November 2014 to September 2015 were analyzed retrospectively. We assessed the prevalence of malnutrition and the risk factors for 2-year mortality. Furthermore, we divided the patients into two groups: elderly (age ≥ 65 years, n = 131) and non-elderly (age < 65 years, n = 67). Subgroup analyses were performed in the elderly group through propensity score matching. The prevalence of malnutrition was 39.4%, and the proportion of patients with malnutrition was significantly higher (53.4% vs. 11.9%, p < 0.001) in the elderly group than in the non-elderly group. In-hospital mortality, 1-year mortality, and 2-year mortality rates were 4.5%, 19.2%, and 26.8%, respectively. Multivariate Cox regression analyses revealed that malnutrition (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.39 to 4.60; p = 0.002) and the Charlson comorbidity index score (OR, 1.30; 95% CI, 1.17 to 1.45; p < 0.001) were associated with 2-year mortality. Malnutrition was common and associated with a poor long-term outcome in patients with CAP, particularly the elderly. A routine nutritional assessment at admission is mandatory as a first step for appropriate nutritional therapy.