Controlling Nutritional Status score: A novel prognostic marker for patients with community-acquired pneumonia

Abstract

Objective: We aimed to investigate the prevalence and prognostic value of malnutrition assessed by Controlling Nutritional Status score in community-acquired pneumonia patients. Methods: All adult patients admitted to our emergency department and hospitalized for community-acquired pneumonia were prospectively followed-up until hospital discharge or death. Nutritional status was assessed with the Controlling Nutritional Status score, which is based on serum albumin levels, total cholesterol levels, and lymphocyte counts. The primary study endpoint was complicated hospital course defined as need for mechanical ventilation, mortality, or intensive care unit admission. Results: Three hundred and five patients (mean age 68.6 +/- 11.2 years and 51.8% female) were enrolled, and 40 patients (13.1%) had complicated hospitalizations. Older patients, patients with more comorbidities, and patients with higher Controlling Nutritional Status scores on admission were tended to have a higher rate of complications during their hospitalization. Multivariate analysis showed that older age (odds ratio 2.55, 95% confidence interval 1.41-4.64, p < 0.001), presence of diabetes (odds ratio 1.54; 95% confidence interval 1.09-3.65; p = 0.004), pneumonia severity index > 3 (odds ratio 1.27, 95% confidence interval 0.524-3.725, p = 0.035), and Controlling Nutritional Status score > 4 (odds ratio 2.23, 95% confidence interval 1.129-3.657, p = 0.001) were independent predictors of complicated hospitalizations. Conclusion: Malnutrition determined by Controlling Nutritional Status score predicts complications in hospitalized patients with community-acquired pneumonia.