Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia?
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-hospitalizati...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-11-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/14/22/4906 |
| _version_ | 1797464297569255424 |
|---|---|
| author | Maria H. Hegelund Camilla K. Ryrsø Christian Ritz Arnold M. Dungu Adin Sejdic Andreas V. Jensen Nikita M. Hansen Christian Mølgaard Rikke Krogh-Madsen Birgitte Lindegaard Daniel Faurholt-Jepsen |
| author_facet | Maria H. Hegelund Camilla K. Ryrsø Christian Ritz Arnold M. Dungu Adin Sejdic Andreas V. Jensen Nikita M. Hansen Christian Mølgaard Rikke Krogh-Madsen Birgitte Lindegaard Daniel Faurholt-Jepsen |
| author_sort | Maria H. Hegelund |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T18:05:15Z |
| format | Article |
| id | doaj.art-8207347a999e4313b335a8a29952b73b |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T18:05:15Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-8207347a999e4313b335a8a29952b73b2023-11-24T09:33:06ZengMDPI AGNutrients2072-66432022-11-011422490610.3390/nu14224906Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia?Maria H. Hegelund0Camilla K. Ryrsø1Christian Ritz2Arnold M. Dungu3Adin Sejdic4Andreas V. Jensen5Nikita M. Hansen6Christian Mølgaard7Rikke Krogh-Madsen8Birgitte Lindegaard9Daniel Faurholt-Jepsen10Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, DenmarkDepartment of Pulmonary and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, DenmarkThe Research Department for Health and Morbidity in the Population, National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, DenmarkDepartment of Pulmonary and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, DenmarkDepartment of Pulmonary and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, DenmarkDepartment of Pulmonary and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, DenmarkDepartment of Nephrology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, DenmarkCentre for Physical Activity Research, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Pulmonary and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, DenmarkDepartment of Infectious Diseases, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkUndernutrition 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.https://www.mdpi.com/2072-6643/14/22/4906community-acquired pneumoniaundernutritionobesityre-hospitalizationmortality |
| spellingShingle | Maria H. Hegelund Camilla K. Ryrsø Christian Ritz Arnold M. Dungu Adin Sejdic Andreas V. Jensen Nikita M. Hansen Christian Mølgaard Rikke Krogh-Madsen Birgitte Lindegaard Daniel Faurholt-Jepsen Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia? Nutrients community-acquired pneumonia undernutrition obesity re-hospitalization mortality |
| title | Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia? |
| title_full | Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia? |
| title_fullStr | Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia? |
| title_full_unstemmed | Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia? |
| title_short | Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia? |
| title_sort | are undernutrition and obesity associated with post discharge mortality and re hospitalization after hospitalization with community acquired pneumonia |
| topic | community-acquired pneumonia undernutrition obesity re-hospitalization mortality |
| url | https://www.mdpi.com/2072-6643/14/22/4906 |
| work_keys_str_mv | AT mariahhegelund areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT camillakryrsø areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT christianritz areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT arnoldmdungu areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT adinsejdic areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT andreasvjensen areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT nikitamhansen areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT christianmølgaard areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT rikkekroghmadsen areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT birgittelindegaard areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia AT danielfaurholtjepsen areundernutritionandobesityassociatedwithpostdischargemortalityandrehospitalizationafterhospitalizationwithcommunityacquiredpneumonia |