Impact of Nutritional Assessment on the Clinical Outcomes of Patients with Non-albicans Candidemia: A Multicenter Study
| Autor: | Jann-Tay Wang, Ing-Moi Hii, Yong-Chen Chen, Yen-Hsu Chen, Wei-Lun Liu, Mao-Wang Ho, Chun-Eng Liu, Fu-Der Wang, Min-Han Hsieh, Yu-Lin Lee, Yi-Chien Lee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Foley catheter fluids and secretions Internal medicine hemic and lymphatic diseases Medicine TX341-641 Nutrition and Dietetics business.industry Septic shock Proportional hazards model Nutrition. Foods and food supply MUST Mortality rate biochemical phenomena metabolism and nutrition medicine.disease equipment and supplies bacterial infections and mycoses Malnutrition Multicenter study nutritional assessment Non albicans candida non-albicans candidemia Concomitant business Food Science |
| Zdroj: | Nutrients Volume 13 Issue 9 Nutrients, Vol 13, Iss 3218, p 3218 (2021) |
| ISSN: | 2072-6643 |
| DOI: | 10.3390/nu13093218 |
| Popis: | Several studies have demonstrated that malnutrition is a negative prognostic factor for clinical outcomes. However, there is limited evidence for the effect of malnutrition on clinical outcomes in patients with candidemia. We investigated the relationship between malnutrition and all-cause 28-day mortality among patients with non-albicans candidemia. Between July 2011 and June 2014, all adult patients with non-albicans candidemia, including C. tropicalis, C. glabrata, C. parapsilosis and so on, were enrolled. The Malnutrition Universal Screening Tool (MUST) scores were used to determine the patients’ nutritional status before the onset of candidemia. A total of 378 patients were enrolled 43.4% developed septic shock and 57.1% had a high risk of malnutrition (MUST ≥ 2). The all-cause 28-day mortality rate was 40.7%. The Cox proportional hazards model revealed that C. tropicalis (HR, 2.01 95% CI, 1.24–3.26 p = 0.005), Charlson comorbidity index (HR, 1.10 95% CI, 1.03–1.18 p = 0.007), Foley catheter use (HR, 1.68 95% CI, 1.21–1.35 p = 0.002), concomitant bacterial infections (HR, 1.55 95% CI, 1.11–2.17 p = 0.010), low platelet count (HR, 3.81 95% CI, 2.45–5.91 p < 0.001), not receiving antifungals initially (HR, 4.73 95% CI, 3.07–7.29 0.001), and MUST ≥ 2 (HR, 1.54 95% CI, 1.09–2.17 p = 0.014) were independently associated with all-cause 28-day mortality. A simple screening tool for nutritional assessment should be used for patients with non-albicans candidemia to detect early clinical deterioration, and a tailored nutritional care plan should be established for malnourished individuals, to improve their clinical outcomes. |
| Databáze: | OpenAIRE |
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