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

Hegelund, Maria Hein; Ryrsø, Camilla Koch; Ritz, Christian; Dungu, Arnold Matovu; Sejdic, Adin; Jensen, Andreas Vestergaard; Hansen, Nikita Misella; Mølgaard, Christian; Krogh-Madsen, Rikke; Lindegaard, Birgitte; Faurholt‐Jepsen, Daniel

doi:10.3390/nu14224906

Cited by 5 publications

(5 citation statements)

References 41 publications

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“…Along with this, a study of patients with CAP showed that adherence to guidelines reduces LOS by 1.8 days (6.5 to 4.7 days) [ 30 ]. Thus, increased focus on guidelines may have improved treatment efficacy, leading to shorter admissions but high 30-day readmission rate [ 3 , 4 , 31 , 32 ]. Likely, LOS had already been shortened as much as possible in patients with CAP, with a median LOS of 5 days [ 33 ], like our findings.…”

Section: Discussionmentioning

confidence: 99%

“…Readmissions after CAP remain challenging, with 24% being readmitted within 30 days [ 3 , 4 , 31 ]. However, there was no sign of a statistically significant association between in-bed cycling or booklet exercise and 90-day readmission risk.…”

Section: Discussionmentioning

confidence: 99%

“…In times of resource constraints, cost-effective healthcare initiatives are warranted. Healthcare systems are financially burdened by CAP, partly because of high readmission rates [ 3 , 4 , 31 ]. According to the Danish Health Data Authority, healthcare costs associated with CAP are approximately $6000 per admission [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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Effect of Exercise Training on Prognosis in Community-acquired Pneumonia: A Randomized Controlled Trial

Ryrsø,

Faurholt-Jepsen,

Ritz

et al. 2024

Clinical Infectious Diseases

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Objective To investigate the effect of standard care (SoC) combined with supervised in-bed cycling (Bed-Cycle) or booklet exercises (Book-Exe) versus SoC in community-acquired pneumonia (CAP). Methods In this randomised controlled trial, 186 patients with CAP were assigned to SoC (n = 62), Bed-Cycle (n = 61), or Book-Exe (n = 63). Primary outcome length of stay (LOS) was analysed with analysis of covariance. Secondary outcomes, 90-day readmission and 180-day mortality, were analysed with Cox proportional hazard regression and readmission days with negative-binominal regression. Results LOS was -2% (95% CI -24 to 25%) and -1% (95% CI -22 to 27%) for Bed-Cycle and Book-Exe, compared to SoC. 90-day readmission was 35.6% for SoC, 27.6% for Bed-Cycle, and 21.3% for Book-Exe. Adjusted hazard ratio (aHR) for 90-day readmission was 0.63 (95% CI 0.33–1.21) and 0.54 (95% CI 0.27–1.08) for Bed-Cycle and Book-Exe compared to SoC. aHR for 90-day readmission for combined exercise was 0.59 (95% CI 0.33–1.03) compared to SoC. aHR for 180-day mortality was 0.84 (95% CI 0.27–2.60) and 0.82 (95% CI 0.26–2.55) for Bed-Cycle and Book-Exe compared to SoC. Number of readmission days was 226 for SoC, 161 for Bed-Cycle, and 179 for Book-Exe. Incidence rate ratio for readmission days was 0.73 (95% CI 0.48–1.10) and 0.77 (95% CI 0.51–1.15) for Bed-Cycle and Book-Exe compared to SoC. Conclusion Although supervised exercise training during admission with CAP did not reduce LOS or mortality, this trial suggests its potential to reduce readmission risk and number of readmission days.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Exercise Training on Prognosis in Community-acquired Pneumonia: A Randomized Controlled Trial

Ryrsø,

Faurholt-Jepsen,

Ritz

et al. 2024

Clinical Infectious Diseases

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“…It has been reported that overweight/obese older patients hospitalized for pneumonia have better 1-year survival [19]. On the other hand, in other studies, the protection of obesity was not significant for 90-day and 180-day mortality of patients with pneumonia [20].…”

Section: Obesity Paradox In Lung Diseasesmentioning

confidence: 99%

Obesity Paradox in Lung Diseases: What Explains It?

Yao¹,

Zeng²,

Wang³

et al. 2023

Obes Facts

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Background: Obesity is a globally increasing health problem that impacts multiple organ systems and a potentially modifiable risk factor for many diseases. Obesity has a significant impact on lung function and is strongly linked to the pathophysiology that contributes to lung diseases. On the other hand, reports have emerged that obesity is associated with a better prognosis than for normal weight individuals in some lung diseases, including pneumonia, acute lung injury/acute respiratory distress syndrome, chronic obstructive pulmonary disease, and lung cancer. The lesser mortality and better prognosis in patients with obesity is known as obesity paradox. While obesity paradox is both recognized and disputed in epidemiological studies, recent research has suggested possible mechanisms. Summary: In this review, we attempted to explain and summarize these factors and mechanisms, including immune response, pulmonary fibrosis, lung function, microbiota, fat and muscle reserves, which are significantly altered by obesity and may contribute to the obesity paradox in lung diseases. We also discuss contrary literature that attributes the “obesity paradox” to confounding. Key Messages: The review will illustrate the possible role of obesity in the prognosis or course of lung diseases, leading to a better understanding of the obesity paradox and provide hints for further basic and clinical research in lung diseases.

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“…Diagnostics 2023, 13, 3356 2 of 14 Although there are numerous ways to measure this excess and its distribution in the body, it is essential to use a simple technique that enables the diagnosis and classification of the problem for epidemiological purposes regardless of race and country [3,4], whether to compare populations, to identify individuals at risk of morbidity and mortality [5][6][7], or to establish priorities for individual and community intervention [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Abdominal Volume Index and Body Adiposity Index and Scales of Insulin Resistance and Metabolic Syndrome

Ramírez-Manent,

López-González,

Tomás-Gil

et al. 2023

Diagnostics

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Introduction, objectives: Obesity is a global health problem with a great negative impact on health. Among the pathologies caused by obesity are insulin resistance and metabolic syndrome, which constitute an increasingly common health problem in both developed and developing countries. The aim of this study was to examine the relationship between two scales that assess obesity—based on hip circumference—and metabolic syndrome (MetS) and insulin resistance risk scales as predictors of these alterations. Materials, methods: A descriptive, cross-sectional study was carried out on 193,462 workers from different Spanish regions and work groups between January 2019 and September 2021. Abdominal volume index (AVI) and body adiposity index (BAI) were evaluated to assess obesity and its association with insulin resistance using three risk scales (TyG index, Triglycerides/HDL, and METS-IR), while their association with metabolic syndrome was determined using the NCEP ATP III, IDF, and JIS models. Results: The results of the ROC curves to determine the predictive value of BAI and AVI in relation to the three criteria evaluated to calculate MetS in all instances presented a higher area under the curve (AUC) for AVI. The high values of AVI stand out for predicting MetS when applying the IDF criteria. The cut-off point in women was 13.70 with a Youden index of 0.802, whereas in men, the cut-off point was set at 17.59 with a Youden index of 0.672. Regarding the relationship of BAI and AVI with insulin resistance risk scales for both sexes, the AUC only revealed high values when using the METS-IR formula for both AVI and BAI. The AVI cut-off points to predict high values of insulin resistance risk scales in women were established at 13.12 with a Youden index of 0.722. In men, the cut-off point was 17.59, with a Youden index of 0.626. The BAI cut-off points in women were set at 33.88 with a Youden index of 0.748. In men, the cut-off point was 27.91, with a Youden index of 0.598. Conclusions: AVI demonstrated its value as a predictor of metabolic syndrome while exclusively applying the IDF criteria. AVI and BAI demonstrated their value as predictors of high values of insulin resistance risk scales only in the case of METS-IR. This predictive value is also higher in women.

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

Cited by 5 publications

References 41 publications

Effect of Exercise Training on Prognosis in Community-acquired Pneumonia: A Randomized Controlled Trial

Effect of Exercise Training on Prognosis in Community-acquired Pneumonia: A Randomized Controlled Trial

Obesity Paradox in Lung Diseases: What Explains It?

Relationship between Abdominal Volume Index and Body Adiposity Index and Scales of Insulin Resistance and Metabolic Syndrome

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