2024 Volume 28 Issue 3 Pages 161-168
Introduction: Dysphagia is associated with a poor prognosis in patients with pneumonia, including increased mortality and prolonged hospitalization. Dysphagia due to sarcopenia is a problem in Japan with its aging population. Malnutrition is one of the major causes of sarcopenia. Although reports on the relationship between malnutrition and swallowing function for each disease are increasing, studies on patients with pneumonia remain scarce. This study used the Global Leadership Initiative on Malnutrition (GLIM), which is a useful diagnostic tool for malnutrition, to investigate the effect of malnutrition on admission on the food intake status at discharge in patients with pneumonia.
Methods: This retrospective cohort study included patients with pneumonia who underwent swallowing rehabilitation between April 2018 and March 2019. The patients’ age, sex, body mass index (BMI), Barthel index, skeletal mass index (SMI), Food Intake LEVEL Scale (FILS), and Charlson comorbidity index were assessed. The primary endpoint was food intake status at discharge, as assessed using the FILS. Malnutrition was assessed using the GLIM on admission, and two-group comparisons were made based on the presence or absence of malnutrition. Multiple regression analysis was performed using the discharge FILS as the dependent variable to analyze the factors associated with the recovery of swallowing function.
Results: Two hundred six participants (85 [51–103] years, 81 women) were included, of which 134 (64.6%) were diagnosed with malnutrition using the GLIM. The malnutrition group had significantly lower BMI, FILS at admission and FILS at discharge. Multiple regression analysis showed that malnutrition upon admission was independently associated with discharge FILS (β＝－0.419, p＝0.003). Patients with malnutrition had a lower rate of recovery of oral intake compared to patients without malnutrition.
Conclusion: Malnutrition on admission negatively affects the food intake status at discharge in patients with pneumonia. Patients with pneumonia and malnutrition on admission may require early nutritional intervention.
