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KMID : 0338420190340040841
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Korean Journal of Internal Medicine
2019 Volume.34 No. 4 p.841 ~ p.849
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Prognostic significance of malnutrition for long-term mortality in community-acquired pneumonia: a propensity score matched analysis
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Yeo Hye-Ju
Byun Ki-Sup
Han Jun-Hee
Kim June-Hyun
Lee Seung-Eun
Yoon Seong-Hoon
Jeon Doo-Soo
Kim Yun-Seong
Cho Woo-Hyun
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Abstract
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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.
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KEYWORD
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Pneumonia, Aged, Functional status, Malnutrition, Prognosis
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