The Global Leadership Initiative on Malnutrition criteria can predict a long-term prognosis among community-onset pneumonia.

Abstract

Introduction: Despite advances in rapid diagnostic tests and antibiotic therapy, pneumonia remains as the leading cause of infection death worldwide. There are few reports documenting a long-term prognosis among patients with pneumonia. We hypothesize that nutritional status could impact a long-term prognosis among pneumonia patients.

Patients and methods: We reviewed all community-onset pneumonia patients admitted to our institute between 2014 and 2017 to examine whether the Global Leadership Initiative on Malnutrition (GLIM) criteria could predict the patients' outcome for a 5-year survival rate.

Results: A total of 406 patients were enrolled in the study, and the 5-year mortality rate was 36%. We analyzed prognostic factors for long-term survival among community-onset pneumonia. Male gender, severe malnutrition status by the GLIM criteria, higher controlling nutritional status (CONUT) score (>6), higher Charlson comorbidity index (CCI) score (>3), and usage of carbapenems as the initial treatment were poor prognostic factors by univariate analysis. Of these 5, cox progressive hazard analysis showed that severe malnutrition status by the GLIM criteria [hazard ratio (HR) 95% confidence interval (CI) 1.45-3.22, p<0.001], higher CCI score (HR 1.76, 95%CI 1.26-2.47, p<0.001), higher CONUT score (HR 1.82, 95%CI 1.29-2.57, p=0.001) were independently poor prognostic factors. Usage of carbapenems as the initial treatment (HR 1.39, 95%CI 0.53-1.11, p=0.077) was not, but almost significant. Malnourished patients, according to the GLIM criteria, had a significantly shorter overall survival time than those without malnutrition (p<0.001 by Long-Ranktest).

Conclusion: Malnutrition, according to the GLIM criteria, could predict 5-year survival among patients with community-onset pneumonia.