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 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.