Wakita Yoshinori, Asai Nobuhiro, Ohashi Wataru, Mori Naoharu, Maekawa Masato, Mikamo Hiroshige
Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Aichi, Japan.
Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Aichi, Japan.
Geriatrics (Basel). 2024 Sep 12;9(5):118. doi: 10.3390/geriatrics9050118.
While prognostic guidelines for pneumonia have widely allowed clinicians to treat patients, poor prognostic factors for 1- or 2-year survival times have never been mentioned to our knowledge.
We conducted this retrospective study to evaluate whether malnutrition according to the GLIM criteria is a poor prognostic factor for 1- or 2-year survival among patients with aspiration pneumonia. All patients with community-onset aspiration pneumonia who were admitted to Aichi Medical University and had intervention from our nutrition support team (NST) in 2019 and 2020 were enrolled in this study.
A total of 56 patients were enrolled in the study. The mean age was 86 ± 6.5 and 25 (45%) were male. Thirty-one patients died during this observational period. Comparing the survival and death group, higher respiratory rate (RR) and malnutrition were seen more frequently in the death group than in the survival group. Then, the patients were divided into the following three groups: those with an RR ≥ 22 and malnutrition, those with malnutrition, and a control group [patients who were not malnourished and had a low RR (<22)]. Comparing the three groups, patients with an RR ≥ 22 and malnutrition had significantly shorter overall survival times (OSs) than those in the other groups ( = 0.009 by test) for 1-year prognosis. The result of 2-year prognosis displayed a statistical significance that was the same as that for 1-year prognosis ( = 0.004 by test). The Cox hazard regression model showed that a higher RR was an independent poor prognostic factor for 1- and 2-year survival among aspiration pneumonia patients.
This pilot study showed that combined scores of higher RR and malnutrition according to the GLIM criteria (modified R-GLIM score) was an independent poor prognostic factor for 1 or 2-year survival among super-elderly patients (aged over 80 years) with aspiration pneumonia.
虽然肺炎的预后指南已广泛允许临床医生治疗患者，但据我们所知，从未提及过1年或2年生存时间的不良预后因素。
我们进行了这项回顾性研究，以评估根据全球营养不良领导倡议（GLIM）标准定义的营养不良是否是吸入性肺炎患者1年或2年生存的不良预后因素。所有2019年和2020年入住爱知医科大学且接受我们营养支持团队（NST）干预的社区获得性吸入性肺炎患者均纳入本研究。
本研究共纳入56例患者。平均年龄为86±6.5岁，男性25例（45%）。在观察期内，31例患者死亡。比较生存组和死亡组，死亡组的呼吸频率（RR）较高和营养不良的情况比生存组更常见。然后，将患者分为以下三组：RR≥22且营养不良的患者、营养不良的患者和对照组[非营养不良且RR较低（<22）的患者]。比较这三组，RR≥22且营养不良的患者1年预后的总生存时间（OS）明显短于其他组（经检验P=0.009）。2年预后结果显示出与1年预后相同的统计学意义（经检验P=0.004）。Cox风险回归模型显示，较高的RR是吸入性肺炎患者1年和2年生存的独立不良预后因素。
这项初步研究表明，根据GLIM标准（改良R-GLIM评分），RR较高和营养不良的综合评分是80岁以上超高龄吸入性肺炎患者1年或2年生存的独立不良预后因素。
