Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study
Xiaoqun Xu1,2 *, Houyong Zhu3 *, Long Cai1,2 *, Xinyu Zhu,4 Hanxin Wang,5 Libin Liu,1,2 Fengwei Zhang,1,2 Hongjuan Zhou,1,2 Jing Wang,1,2 Tielong Chen,3 Kan Xu1,2 1Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangz...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-10-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/malnutrition-is-associated-with-an-increased-risk-of-death-in-hospital-peer-reviewed-fulltext-article-IDR |
| _version_ | 1811247712006307840 |
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| author | Xu X Zhu H Cai L Zhu X Wang H Liu L Zhang F Zhou H Wang J Chen T Xu K |
| author_facet | Xu X Zhu H Cai L Zhu X Wang H Liu L Zhang F Zhou H Wang J Chen T Xu K |
| author_sort | Xu X |
| collection | DOAJ |
| description | Xiaoqun Xu1,2 *, Houyong Zhu3 *, Long Cai1,2 *, Xinyu Zhu,4 Hanxin Wang,5 Libin Liu,1,2 Fengwei Zhang,1,2 Hongjuan Zhou,1,2 Jing Wang,1,2 Tielong Chen,3 Kan Xu1,2 1Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 4Department of Cardiology, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 5The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kan Xu, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Hangzhou, 310003, People’s Republic of China, Email xukan3787@qq.com Tielong Chen, Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Stadium Road, Hangzhou, 310007, People’s Republic of China, Email ctlppp@foxmail.comBackground: This study aimed to investigate whether nutrition levels in patients with active pulmonary tuberculosis (TB) affect their risk of all-cause mortality during hospitalization and to further evaluate the predictive ability of Geriatric Nutritional Risk Index (GNRI) and Body Mass Index (BMI) for risk of all-cause mortality.Methods: Patients from January 1, 2020 to December 31, 2021 were retrieved, and a total of 1847 were included. The primary outcome was all-cause mortality. Propensity score matching (PSM) was performed for risk adjustment, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive ability of GNRI and BMI for all-cause mortality.Results: Malnourished TB patients were older, had more congestive heart failure, and had more chronic obstructive pulmonary disease or asthma. Under the nutrition level grouping defined by GNRI, the all-cause mortality in the malnourished group did not appear to reach a statistical difference compared with the nonmalnourished group (P = 0.078). When grouped by level of nutrition as defined by BMI, the all-cause mortality was higher in the malnourished group (P = 0.009), and multivariate logistic regression analysis revealed that malnutrition was an independent risk factor for all-cause mortality. After propensity score matching, the results showed that the all-cause mortality was higher in the malnutrition group, regardless of BMI or GNRI defined nutrition level grouping, compared with the control group (both P < 0.001). The ROC curve analysis revealed that the area under the curve (AUC) was 0.811 ([95% confidence interval (CI) 0.701– 0.922], P < 0.001) for GNRI and 0.728 ([95% CI 0.588– 0.869], P = 0.001) for BMI.Conclusion: In the clinical treatment of patients with active TB, more attention should be paid to the management of nutritional risk. GNRI may be a highly effective and easy method for predicting short-term outcomes in patients with active pulmonary TB.Keywords: tuberculosis, malnutrition, Geriatric Nutritional Risk Index, body mass index |
| first_indexed | 2024-04-12T15:14:27Z |
| format | Article |
| id | doaj.art-cb04eb8d1a354531a6269044f14d26f7 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-12T15:14:27Z |
| publishDate | 2022-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-cb04eb8d1a354531a6269044f14d26f72022-12-22T03:27:39ZengDove Medical PressInfection and Drug Resistance1178-69732022-10-01Volume 156155616479215Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort StudyXu XZhu HCai LZhu XWang HLiu LZhang FZhou HWang JChen TXu KXiaoqun Xu1,2 *, Houyong Zhu3 *, Long Cai1,2 *, Xinyu Zhu,4 Hanxin Wang,5 Libin Liu,1,2 Fengwei Zhang,1,2 Hongjuan Zhou,1,2 Jing Wang,1,2 Tielong Chen,3 Kan Xu1,2 1Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 4Department of Cardiology, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 5The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kan Xu, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Hangzhou, 310003, People’s Republic of China, Email xukan3787@qq.com Tielong Chen, Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Stadium Road, Hangzhou, 310007, People’s Republic of China, Email ctlppp@foxmail.comBackground: This study aimed to investigate whether nutrition levels in patients with active pulmonary tuberculosis (TB) affect their risk of all-cause mortality during hospitalization and to further evaluate the predictive ability of Geriatric Nutritional Risk Index (GNRI) and Body Mass Index (BMI) for risk of all-cause mortality.Methods: Patients from January 1, 2020 to December 31, 2021 were retrieved, and a total of 1847 were included. The primary outcome was all-cause mortality. Propensity score matching (PSM) was performed for risk adjustment, and receiver operating characteristic (ROC) curve analysis was performed to assess the predictive ability of GNRI and BMI for all-cause mortality.Results: Malnourished TB patients were older, had more congestive heart failure, and had more chronic obstructive pulmonary disease or asthma. Under the nutrition level grouping defined by GNRI, the all-cause mortality in the malnourished group did not appear to reach a statistical difference compared with the nonmalnourished group (P = 0.078). When grouped by level of nutrition as defined by BMI, the all-cause mortality was higher in the malnourished group (P = 0.009), and multivariate logistic regression analysis revealed that malnutrition was an independent risk factor for all-cause mortality. After propensity score matching, the results showed that the all-cause mortality was higher in the malnutrition group, regardless of BMI or GNRI defined nutrition level grouping, compared with the control group (both P < 0.001). The ROC curve analysis revealed that the area under the curve (AUC) was 0.811 ([95% confidence interval (CI) 0.701– 0.922], P < 0.001) for GNRI and 0.728 ([95% CI 0.588– 0.869], P = 0.001) for BMI.Conclusion: In the clinical treatment of patients with active TB, more attention should be paid to the management of nutritional risk. GNRI may be a highly effective and easy method for predicting short-term outcomes in patients with active pulmonary TB.Keywords: tuberculosis, malnutrition, Geriatric Nutritional Risk Index, body mass indexhttps://www.dovepress.com/malnutrition-is-associated-with-an-increased-risk-of-death-in-hospital-peer-reviewed-fulltext-article-IDRtuberculosismalnutritiongeriatric nutritional risk indexbody mass index |
| spellingShingle | Xu X Zhu H Cai L Zhu X Wang H Liu L Zhang F Zhou H Wang J Chen T Xu K Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study Infection and Drug Resistance tuberculosis malnutrition geriatric nutritional risk index body mass index |
| title | Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study |
| title_full | Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study |
| title_fullStr | Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study |
| title_full_unstemmed | Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study |
| title_short | Malnutrition is Associated with an Increased Risk of Death in Hospitalized Patients with Active Pulmonary Tuberculosis: A Propensity Score Matched Retrospective Cohort Study |
| title_sort | malnutrition is associated with an increased risk of death in hospitalized patients with active pulmonary tuberculosis a propensity score matched retrospective cohort study |
| topic | tuberculosis malnutrition geriatric nutritional risk index body mass index |
| url | https://www.dovepress.com/malnutrition-is-associated-with-an-increased-risk-of-death-in-hospital-peer-reviewed-fulltext-article-IDR |
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