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. 2022 Oct 26:15:6155-6164.
doi: 10.2147/IDR.S382587. eCollection 2022.

Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study

Xiaoqun Xu #  1   2 , Houyong Zhu #  3 , Long Cai #  1   2 , Xinyu Zhu  4 , Hanxin Wang  5 , Libin Liu  1   2 , Fengwei Zhang  1   2 , Hongjuan Zhou  1   2 , Jing Wang  1   2 , Tielong Chen  3 , Kan Xu  1   2
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Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study

Xiaoqun Xu et al. Infect Drug Resist. .

Abstract

Background: This study aimed to investigate whether nutrition levels in patients with active pulmonary tuberculosis (TB) affect their risk of all-cause mortality during hospitalization and to further evaluate the predictive ability of Geriatric Nutritional Risk Index (GNRI) and Body Mass Index (BMI) for risk of all-cause mortality.

Methods: Patients from January 1, 2020 to December 31, 2021 were retrieved, and a total of 1847 were included. The primary outcome was all-cause mortality. Propensity score matching (PSM) was performed for risk adjustment, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive ability of GNRI and BMI for all-cause mortality.

Results: Malnourished TB patients were older, had more congestive heart failure, and had more chronic obstructive pulmonary disease or asthma. Under the nutrition level grouping defined by GNRI, the all-cause mortality in the malnourished group did not appear to reach a statistical difference compared with the nonmalnourished group (P = 0.078). When grouped by level of nutrition as defined by BMI, the all-cause mortality was higher in the malnourished group (P = 0.009), and multivariate logistic regression analysis revealed that malnutrition was an independent risk factor for all-cause mortality. After propensity score matching, the results showed that the all-cause mortality was higher in the malnutrition group, regardless of BMI or GNRI defined nutrition level grouping, compared with the control group (both P < 0.001). The ROC curve analysis revealed that the area under the curve (AUC) was 0.811 ([95% confidence interval (CI) 0.701-0.922], P < 0.001) for GNRI and 0.728 ([95% CI 0.588-0.869], P = 0.001) for BMI.

Conclusion: In the clinical treatment of patients with active TB, more attention should be paid to the management of nutritional risk. GNRI may be a highly effective and easy method for predicting short-term outcomes in patients with active pulmonary TB.

Keywords: Geriatric Nutritional Risk Index; body mass index; malnutrition; tuberculosis.

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Conflict of interest statement

The authors report no conflicts of interest in relation to this work.

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References

    1. World Health Organization. Global Tuberculosis Report 2021. Geneva, Switzerland: World Health Organization; 2021. Available from: https://apps.who.int/iris/bitstream/handle/10665/346387/9789240037021-en.... Accessed October 14, 2022.
    1. Di Gennaro F, Gualano G, Timelli L, et al. Increase in tuberculosis diagnostic delay during first wave of the COVID-19 pandemic: data from an italian infectious disease referral hospital. Antibiotics. 2021;10(3). doi:10.3390/antibiotics10030272 - DOI - PMC - PubMed
    1. Sinha P, Davis J, Saag L, et al. Undernutrition and tuberculosis: public health implications. J Infect Dis. 2019;219(9):1356–1363. doi:10.1093/infdis/jiy675 - DOI - PMC - PubMed
    1. Prezzemolo T, Guggino G, La Manna MP, Di Liberto D, Dieli F, Caccamo N. Functional signatures of human CD4 and CD8 T cell responses to Mycobacterium tuberculosis. Front Immunol. 2014;5:180. doi:10.3389/fimmu.2014.00180 - DOI - PMC - PubMed
    1. Dai G, Phalen S, McMurray DN. Nutritional modulation of host responses to mycobacteria. Front Biosci. 1998;3:e110–e122. doi:10.2741/A371 - DOI - PubMed