Korean J Intern Med.  2019 Jul;34(4):841-849. 10.3904/kjim.2018.037.

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

Affiliations
  • 1Department of Pulmonology and Critical Care Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. popeyes0212@hanmail.net
  • 2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 3Department of Statistics, Hallym University, Chuncheon, Korea.
  • 4Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

Abstract

BACKGROUND/AIMS
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Pneumonia; Aged; Functional status; Malnutrition; Prognosis

MeSH Terms

Adult
Aged
Comorbidity
Hospital Mortality
Humans
Malnutrition*
Mortality*
Nutrition Assessment
Pneumonia*
Prevalence
Prognosis
Propensity Score*
Retrospective Studies
Risk Factors
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