Modified R-GLIM Score Is a Good Prognostic Tool to Predict a Long-Term Prognosis in Poor Conditioned Elderly Patients with Aspiration Pneumonia, a Pilot Study

• Published in: Geriatrics (Basel) Vol. 9; no. 5; p. 118
• Main Authors: Wakita, Yoshinori, Asai, Nobuhiro, Ohashi, Wataru, Mori, Naoharu, Maekawa, Masato, Mikamo, Hiroshige
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12-09-2024; MDPI
• Subjects: Aged patients; Antibiotics; Aspiration pneumonia; Care and treatment; Comorbidity; Demographic aspects; Diagnosis; Drug resistance; high respiratory rate; Hospitals; Malnutrition; Medical prognosis; modified GLIM criteria; Nutrition; Nutritional status; Pathogens; Pilot projects; Pneumonia; Prognosis; Regression analysis; Staphylococcus infections; Japan; aspiration pneumonia; malnutrition; modified GLIM criteria; high respiratory rate
• ISSN: 2308-3417; 2308-3417
• 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.