Are Undernutrition and Obesity Associated with Post-Discharge Mortality and Re-Hospitalization after Hospitalization with Community-Acquired Pneumonia?

Maria H. Hegelund*, Camilla K. Ryrsø, Christian Ritz, Arnold M. Dungu, Adin Sejdic, Andreas V. Jensen, Nikita M. Hansen, Christian Mølgaard, Rikke Krogh-Madsen, Birgitte Lindegaard, Daniel Faurholt-Jepsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Undernutrition is associated with increased mortality after hospitalization with community-acquired pneumonia (CAP), whereas obesity is associated with decreased mortality in most studies. We aimed to determine whether undernutrition and obesity are associated with increased risk of re-hospitalization and post-discharge mortality after hospitalization. This study was nested within the Surviving Pneumonia cohort, which is a prospective cohort of adults hospitalized with CAP. Patients were categorized as undernourished, well-nourished, overweight, or obese. Undernutrition was based on diagnostic criteria by the European Society for Clinical Nutrition and Metabolism. Risk of mortality was investigated using multivariate logistic regression and re-hospitalization with competing risk Cox regression where death was the competing event. Compared to well-nourished patients, undernourished patients had a higher risk of 90-day (OR 3.0, 95% CI 1.0; 21.4) mortality, but a similar 30-day and 180-day mortality risk. Obese patients had a similar re-hospitalization and mortality risk as well-nourished patients. In conclusion, among patients with CAP, undernutrition was associated with increased risk of mortality. Undernourished patients are high-risk patients, and our results indicate that in-hospital screening of undernutrition should be implemented to identify patients at mortality risk. Studies are required to investigate whether nutritional therapy after hospitalization with CAP would improve survival.

Original languageEnglish
Article number4906
Issue number22
Number of pages13
Publication statusPublished - 19. Nov 2022

Bibliographical note

Funding Information:
The study was supported by grants from the Research Council at Copenhagen University Hospital, North Zealand, Denmark, and Helsefonden (19-B-0155). The funding sources were not involved in study design, data collection, data analysis, interpretation of data, drafting the manuscript, or deciding where to submit the manuscript for publication.


  • community-acquired pneumonia
  • mortality
  • obesity
  • re-hospitalization
  • undernutrition


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