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. 2022 Nov 19;14(22):4906.
doi: 10.3390/nu14224906.

Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia?

Maria H Hegelund  1 , Camilla K Ryrsø  1   2 , Christian Ritz  3 , Arnold M Dungu  1 , Adin Sejdic  1 , Andreas V Jensen  1   4 , Nikita M Hansen  5 , Christian Mølgaard  6   7 , Rikke Krogh-Madsen  2   8 , Birgitte Lindegaard  1   2   9 , Daniel Faurholt-Jepsen  4
Affiliations

Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia?

Maria H Hegelund et al. Nutrients. .

Abstract

Undernutrition is associated with increased mortality after hospitalization with community-acquired pneumonia (CAP), whereas obesity is associated with decreased mortality in most studies. We aimed to determine whether undernutrition and obesity are associated with increased risk of re-hospitalization and post-discharge mortality after hospitalization. This study was nested within the Surviving Pneumonia cohort, which is a prospective cohort of adults hospitalized with CAP. Patients were categorized as undernourished, well-nourished, overweight, or obese. Undernutrition was based on diagnostic criteria by the European Society for Clinical Nutrition and Metabolism. Risk of mortality was investigated using multivariate logistic regression and re-hospitalization with competing risk Cox regression where death was the competing event. Compared to well-nourished patients, undernourished patients had a higher risk of 90-day (OR 3.0, 95% CI 1.0; 21.4) mortality, but a similar 30-day and 180-day mortality risk. Obese patients had a similar re-hospitalization and mortality risk as well-nourished patients. In conclusion, among patients with CAP, undernutrition was associated with increased risk of mortality. Undernourished patients are high-risk patients, and our results indicate that in-hospital screening of undernutrition should be implemented to identify patients at mortality risk. Studies are required to investigate whether nutritional therapy after hospitalization with CAP would improve survival.

Keywords: community-acquired pneumonia; mortality; obesity; re-hospitalization; undernutrition.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow of inclusion in the study.
Figure 2
Figure 2
Kaplan-Meier estimates of probability of not having a re-hospitalization (A) and survival (B) among undernourished, well-nourished, and obese patients after discharge from hospitalization with community acquired-pneumonia.
See this image and copyright information in PMC

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