营养不良全球领导倡议标准可以预测社区发病肺炎的长期预后。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-03-25 DOI:10.1016/j.clnesp.2025.03.020

Nobuhiro Asai , Wataru Ohashi , Hideo Kato , Mao Hagihara , Hiroshige Mikamo

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引用次数: 0

摘要

导论：尽管在快速诊断测试和抗生素治疗方面取得了进展，但肺炎仍然是全世界感染死亡的主要原因。很少有报告记录肺炎患者的长期预后。我们假设营养状况可能影响肺炎患者的长期预后。患者和方法：我们回顾了2014年至2017年间我院收治的所有社区发病肺炎患者，以检验全球营养不良领导倡议（GLIM）标准是否可以预测患者5年生存率的结果。结果：共纳入406例患者，5年死亡率为36%。我们分析了影响社区发病肺炎患者长期生存的预后因素。单因素分析显示，男性、GLIM标准的严重营养不良状况、较高的控制营养状况（CONUT）评分（bbbb6）、较高的Charlson合病指数（CCI）评分（bbbb3）以及初始治疗时使用碳青霉烯类药物是不良预后因素。其中，cox渐进式风险分析显示，根据GLIM标准，严重营养不良状态[风险比（HR） 95%可信区间（CI） 1.45-3.22]结论：根据GLIM标准，营养不良可以预测社区发病肺炎患者的5年生存。

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The global leadership initiative on malnutrition criteria can predict a long-term prognosis among community-onset pneumonia

Introduction

Despite advances in rapid diagnostic tests and antibiotic therapy, pneumonia remains the leading cause of infection-related death worldwide. Few reports document a long-term prognosis among patients with pneumonia. We hypothesize that nutritional status could impact this prognosis.

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 anti-pseudomonal agents 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) 2.3, 95% confidence interval (CI) 1.56–3.39, p < 0.001], higher CCI score (HR 1.7, 95%CI 1.22–2.37, p = 0.002), higher CONUT score (HR 1.66, 95%CI 1.18–2.33, p = 0.003) and usage of anti-pseudomonal agents (HR 1.76, 95%CI 1.23–2.53, p = 0.002) were independently poor prognostic factors. Malnourished patients by the GLIM criteria had a significantly shorter overall survival time than those without malnutrition (p < 0.001 by Long-Rank test).

Conclusion

The GLIM criteria could predict 5-year survival among patients with community-onset pneumonia.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.