Frontiers in Public Health (Dec 2022)

Prevalence and prognostic significance of malnutrition risk in patients with pulmonary tuberculosis: A hospital-based cohort study

  • Jiao-Jie Ma,
  • Yi-Jia Guo,
  • Yi-Jia Guo,
  • Zhuo Li,
  • Yang Chen,
  • Hong He,
  • Wei-Min Li,
  • Wei-Min Li,
  • Wei-Min Li

DOI
https://doi.org/10.3389/fpubh.2022.1039661
Journal volume & issue
Vol. 10

Abstract

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BackgroundThe prevalence and prognostic significance of malnutrition risk remain unclear in Chinese patients with pulmonary tuberculosis. Therefore, we aimed to investigate the malnutrition risk in Chinese patients and explore the relationship between malnutrition risk and follow-up outcomes.MethodsWe conducted a hospital-based cohort study from January 2020 to December 2020. Malnutrition risks were evaluated using nutritional scales, including the Nutritional Risk Screening 2002 (NRS-2002), the controlling nutritional status score (CONUT), the geriatric nutritional risk index (GNRI), and the prognostic nutritional index (PNI). The primary outcome was all-cause mortality at a one-year follow-up. Malnutrition risk was calculated, and the relationship between malnutrition and follow-up outcomes was analyzed. We assessed the performance of malnutrition risks to predict clinical outcomes in prognostic models.ResultsA total of 1,075 patients were included. According to NRS-2002, CONUT, GNRI, and PNI, 818 (76.09%), 954 (88.74%), 682 (63.44%), and 364 (33.86%) patients were at risk of malnutrition, respectively. Before 1-year follow-up, a total of 99 patients (9.2%) had died. After adjustment for risk factors, the association between severe malnutrition in CONUT (HR = 4.78, 95% CI: 1.14–20.11, P = 0.033), GNRI (HR = 3.53, 95% CI: 1.70–7.34, P = 0.001), or PNI (HR = 2.94, 95% CI: 1.76–4.88, P < 0.001) and death before 1-year follow-up remained significant. The addition of the nutritional scales to prognostic models improved death prediction, as validated by the integrated discrimination index (all P-values of <0.05).ConclusionMalnutrition in patients with pulmonary tuberculosis was associated with an increased risk of all-cause death in the long-term follow-up. Our findings provided evidence for the use of admission nutrition screening in patients with pulmonary tuberculosis.

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