Impact of Protein Energy Malnutrition on Outcomes of Adults With Viral Pneumonia: A Nationwide Retrospective Analysis

Trelles-Garcia, Valeria Patricia; Trelles-Garcia, Daniela Patricia; Kichloo, Asim; Raghavan, Sairam; Ojemolon, Pius; Eseaton, Precious Obehi; Idolor, Osahon N

doi:10.7759/cureus.12274

Cited by 3 publications

(6 citation statements)

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Section: Effect Of Malnutrition On Clinical Outcomes In Capmentioning

confidence: 99%

“…Studies that have evaluated undernutrition and prognosis in CAP in adults use different definitions of nutritional status ( Table 1 ) [ 12 , 13 , 38 , 39 , 40 , 41 , 42 , 43 ]. Undernutrition or poor nutritional status have been associated with unfavorable clinical outcomes in adult patients with CAP [ 12 , 13 , 38 , 39 , 40 , 41 , 42 , 43 ], such as prolonged length of hospital stay (LOS) [ 12 , 38 , 39 , 41 ], need for ICU admission [ 42 ], or mortality [ 12 , 13 , 39 , 40 , 42 , 43 ]. In a retrospective cohort study in patients with CAP in Japan carried out between 2014 and 2018, Shimizu et al [ 41 ] associated severe undernutrition in patients ≥ 70 years with higher 30-day in-hospital mortality and 30-day readmission, and prolonged LOS.…”

Section: Effect Of Malnutrition On Clinical Outcomes In Capmentioning

confidence: 99%

“…Recently, underweight or low BMI values were significantly associated with a higher risk of 30-day, 6-month, and 1-year mortality in hospitalized patients with CAP [ 14 ]. Interestingly, a retrospective cohort study conducted in the US in patients hospitalized with CAP of viral etiology (influenza, adenovirus, parainfluenza, respiratory syncytial virus, and human metapneumovirus) found that only 5% of the study population was diagnosed with protein-energy malnutrition (PEM), though PEM was associated with increased mortality, septic shock, pulmonary embolism, mechanical ventilation, and prolonged LOS [ 13 ]. Another study reported prolongation of fever in patients with CAP when serum albumin levels were low [ 39 ].…”

Section: Effect Of Malnutrition On Clinical Outcomes In Capmentioning

confidence: 99%

“…Undernutrition and obesity have frequently been reported in patients with CAP and have been associated with variable short- and long-term outcomes, such as clinical failure, and 30-day or 1-year mortality [ 12 , 13 , 14 ]. The prognosis of patients with malnutrition and CAP appears to differ according to the patient population, the setting, and the outcome measure assessed.…”

Section: Introductionmentioning

confidence: 99%

“…The prognosis of patients with malnutrition and CAP appears to differ according to the patient population, the setting, and the outcome measure assessed. Studies have documented that undernutrition has been related with worse prognosis in patients with CAP, while obesity has been associated with a lower risk of mortality [ 12 , 13 , 14 , 15 , 16 ]. However, the results of the studies vary depending on the etiology of CAP [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Undernutrition and Obesity on Clinical Outcomes in Adults with Community-Acquired Pneumonia

2022

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Malnutrition comprises two groups of conditions: undernutrition and overweight or obesity. It has been associated with a high risk of contracting infectious diseases and with elevated mortality rates. Community-acquired pneumonia (CAP) is one of the most common infectious diseases worldwide and its prognosis is affected by a large number of recognizable risk factors. This narrative review updates the information on the impact of malnutrition, including both undernutrition and obesity, on the risk and prognosis of adults with CAP. Studies of CAP that have evaluated undernutrition have applied a variety of definitions when assessing the nutritional status of patients. Undernutrition has been associated with unfavorable clinical outcomes, such as prolonged hospital stay, need for intensive care unit admission, and mortality; in contrast, most published studies have found that increased body mass index is significantly associated with higher survival in patients with CAP. However, some authors have presented divergent results, mainly in relation to the etiology of CAP (bacterial versus viral). Influenza infection, caused by influenza A (H1N1) pdm09, has been associated with worse prognosis in obese patients. The current data underscore the need for larger studies to examine the physiological mechanisms that explain the differential impact of malnutrition on outcomes. Achieving a better understanding may help to guide the design of new interventions to improve prognosis.

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Section: Effect Of Malnutrition On Clinical Outcomes In Capmentioning

confidence: 99%

Section: Effect Of Malnutrition On Clinical Outcomes In Capmentioning

confidence: 99%

Section: Effect Of Malnutrition On Clinical Outcomes In Capmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Undernutrition and Obesity on Clinical Outcomes in Adults with Community-Acquired Pneumonia

2022

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Community-Acquired Pneumonia Recognition by Wavelet Entropy and Cat Swarm Optimization

2022

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Aim) Community-acquired pneumonia (CAP) is a type of pneumonia acquired outside the hospital.(Methods) To recognize CAP more efficiently and more precisely, we propose a novel method-wavelet entropy (WE) is used as the feature extractor, and cat swarm optimization (shortened as CSO) is used to train an artificial neural network (ANN). Our method is abbreviated as WE-ANN-CSO. (Results) This proposed WE-ANN-CSO algorithm yields a sensitivity of 91.64±0.99%, a specificity of 90.64±2.11%, a precision of 90.96±1.81%, an accuracy of 91.14±1.12%, an F1 score of 91.29±1.04%, an MCC of 82.31±2.22%, an FMI of 91.29±1.03%, and an AUC of 0.9527.(Conclusions) This proposed WE-ANN-CSO algorithm provides better performances than four state-of-the-art approaches.

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

et al. 2022

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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.

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Impact of Protein Energy Malnutrition on Outcomes of Adults With Viral Pneumonia: A Nationwide Retrospective Analysis

Abstract: Trelles-Garcia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 3 publications

References 28 publications

Effect of Undernutrition and Obesity on Clinical Outcomes in Adults with Community-Acquired Pneumonia

Effect of Undernutrition and Obesity on Clinical Outcomes in Adults with Community-Acquired Pneumonia

Community-Acquired Pneumonia Recognition by Wavelet Entropy and Cat Swarm Optimization

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

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