Interstitial lung disease (ILD) is a group of more than 200 conditions with various etiologies that result in a wide range of inflammation and/or fibrosis of the pulmonary interstitium. Cryptogenic Organizing Pneumonia (COP) is a type of idiopathic ILD that requires a high index of suspicion with an appropriate workup to make the diagnosis. The Coronavirus Disease 2019 (COVID-19) pandemic has enabled COVID-19 pneumonia to become a top differential diagnosis, which has consequently introduced bias into medical decision-making. We present a case of COP that was misdiagnosed for COVID-19 pneumonia for months despite several negative COVID-19 test results. This case also raises awareness of the cognitive bias that likely allowed for the misdiagnosis, resulting in delayed appropriate treatment for this patient.
Introduction: The COVID-19 pandemic has resulted in millions of deaths around the world with a heavy impact on social and health systems. The objective of this study was to analyze not only the profile of cases of deaths that have occurred since the advent of the pandemic in Togo, but also the determinants of their time of occurrence. Method: This was a cross-sectional study in which the Lome-Commune Regional Hospital, a COVID-19 care center, served as the framework for our study. The study population consisted of all patients admitted for COVID-19 confirmed by a positive PCR test for SARS-COV-2, aged 18 years and over and who died during their hospital stay. Results: Sixty-seven patients were included. Males were most represented in 62.7% of cases. Almost six out of 10 patients were over 50 years old. The two main comorbidities found in the patients were hypertension (44.8%) and diabetes (28.4%). The majority of patients had the severe form of COVID-19 in 46.3% of cases. Slightly less than half of the patients (49.3%) died within five days of admission. Degree of glycemia elevation (p<0.01), AST elevation (p = 0.012), and ALT elevation (p<0.01) levels were statistically associated with time of occurrence of deaths. Conclusion: Glycemia and liver enzyme disturbances (AST and ALT) can be used as prognostic predictors in the sorting of patients admitted to hospital for COVID-19 and thus plan the implementation of adequate therapies to safeguard their vital prognosis.
Hodgkin lymphoma counts for 15 to 25% of all lymphomas. Cardiac tumors are divided into primary and secondary tumors. Cardiac Lymphomas whether primary or secondary are rare. The most common imaging modality used to diagnose cardiac tumors is Echocardiography. Trans esophageal Echocardiography is superior to Transthoracic Echocardiography with higher sensitivity and specificity. Positron-emission tomography (PET)/ Computed Tomography scan and cardiac Magnetic Resonance Imaging (MRI) are other modalities used for diagnosis. Chemotherapy is currently the main treatment option for Lymphomas. We report a case of a 31-year-old-male who presented with abdominal pain, weight loss and intermittent vomiting and was diagnosed to have Hodgkin’s Lymphoma with cardiac involvement. Patient received chemotherapy and showed complete resolution. In this case report, we compare the different imaging modalities including CT scanning, Transthoracic Echocardiography, Trans-esophageal Echocardiography, and the PET/CT Scan that was done for the patient before and after treatment.
Objectives: The aim of this study was to describe the epidemiological and clinical profile of dermatological emergencies admitted to the medical emergency department of the Sylvanus Olympio University Hospital (SO) in Lome. Methodology: This is a retrospective study conducted from January 2014 to December 2016 at the medical emergency department of the Sylvanus Olympio University Hospital of Lome. Results: During the study period, 24225 patients were seen at the medical emergency department of the Sylvanus Olympio University Hospital, of which 116 dermatological emergencies, i.e. a frequency of 0.47%. The mean age of the patients was 38.43 years (extremes: 16 and 85 years) and the sex ratio (M/F) was 0.68. The dermatological emergencies were: Leg Erysipelas (N=53; 45.68%), Chickenpox (N=21; 18.10%), herpes zoster (N=13; 11.2%), Stevens-Johnson and Lyell syndromes SJS/TEN (N=22; 18.95%), and Angioedema or Quincke’s edema (N=7; 6.03%). Conclusion: This study showed that skin pathologies were extremely rare in the medical emergencies of the Sylvanus Olympio University Hospital, and dominated by infectious causes.
Background: Airway Tract Infections (ATIs) are one of the most common reasons for physician visits and hospitalization is associated with significant morbidity and mortality. There are many children suffering from frequent lower airway infections (FLAI). A significant number of congenital heart diseases (CHD) remain behind the FLAI but these could not be diagnosed due to lack of practices, investigation facilities, regularly follow-up and proper knowledge. The aim of the study is to identify the impact of birth-defect in heart among patients with FLAI. Methodology: This was a prospective observational study conducted in the Department of Paediatrics in Medical College Hospital over a period of 6 months. Total 50 cases of FLAI were included and data were collected in respect to history, examinations and diagnosis. Results: Out of these 36% of cases were diagnosed as CHD which are related to FLAI and 64% cases were remaining solely FLAI without any CHD. Conclusion: From the study, birth-defect in heart is an important cause of frequent lower respiratory infection. It can be prevented for earlier recognition and effective treatment. The study explores for future research trajectories for improvement of physical condition in children for proper diagnosis and prevention of recurrent attack by proper management.
Background: Increased 25-hydroxyvitamin D (25OHD) testing, driven by studies linking vitamin D (VD) deficiency with many diseases has been challenged due to cost and uncertain health benefits. Insight to current practices in VD testing and replacement can inform development of strategies to ensure judicious testing. Objectives: To assess trends in 25OHD testing and appropriateness, VD status change, VD regimens prescribed, and factors associated with reaching sufficient levels at retest. Design: Single center retrospective large data analysis study in Singapore General Hospital. Subjects: Adults with 25OHD assays performed from 2011 to 2016. Main measures: Data (25OHD tests, patient demographics, co-morbidities and medications) were electronically extracted. Linear regression and chi-square test were used to compare annual change for continuous and categorical variables respectively. McNemar test was used to compare VD status change at retest between adults with low (25OHD 30ng/mL) baseline levels. Multivariate logistic regression was used to identify factors associated with achieving sufficient levels. Key Results: Total of 25,502 25OHD tests were performed in 15,605 adults. Annual tests increased 3.4 fold from 2,125 to 7,236 tests in 2012 and 2016 (p 1,000units/day) (OR 1.23, CI 1.003-1.51, p=0.05). Conclusion: There was an uptrend in 25OHD tests over time. While adults were aptly tested, VD status didn’t improve with repeated testing. High VD doses and no risk conditions were associated with achieving sufficient levels.
BACKGROUND: The incidence of cancer is increasing worldwide and particularly in the sub-Saharan Africa as shown by cancer data published by World Health Organization. Nigeria like many countries in the West African region is experiencing an increase in cancer incidence, yet there is no centre exclusively devoted to cancer care and cancer research. It is said that environmental factors play a significant role in the causation of cancer, so it is important to know the pattern of cancer distribution in a specific geographical location.In Nigeria, there seems to be a changing pattern in the trends of some cancers during the last four decades. AIM & OBJECTIVE: The aim of the study is to describe the pattern of cancers seen in Ife-Ijesha zone, Southwestern Nigeria as recorded in the hospital-based Ife-Ijesha cancer registry between January 1991 to December 2010. The main objective of the study is to describe the pattern of cancer seen with reference to age, sex and site. MATERIALS AND METHODS: The study is a retrospective study of all cases of malignant tumour recorded in the Ife-Ijesha cancer registry which is located in the Department of Morbid Anatomy & Forensic Medicine of the Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife, Nigeria between January 1991 and December 2010. RESULTS: The total number of cancers recorded in the 20 years period that met the inclusions criteria were 6405. Out of these, 3498 (54.6%) were seen in females while 2907 (45.4%) were seen in males. Total number of malignant tumours recorded in paediatric age group was 692 (10.8%). The common malignant tumours in males in order of decreasing frequency were prostate cancer, non-Hodgkin’s lymphoma, liver cancer and soft tissue sarcoma. In females, breast cancer was on top followed by cancer of the cervix, non-Hodgkin’s lymphoma, leukaemia and soft tissue tumours. There is an increasing trend in the incidence of breast cancer, prostate cancer and non-Hodgkin’s lymphoma. However, cervical cancer showed a decline. CONCLUSIONS: This study has shown a probable rising trend in the pattern of non-Hodgkin’s lymphoma recorded in Ife-Ijesha cancer registry. On the other hand, prostate cancer and cancer of the breast remained consistently the most frequent cancer in the males and females respectively. Lung cancer and Kaposi’s sarcoma that are commonly seen in the Northern and Eastern regions of Africa are rare in this study.
Gastrointestinal cancer occupies almost half of all tumors which occur in today's time. Etiology tumor formation at the molecular level is now the subject of many studies, it mentioned that the number of factors from hereditary to acquired mutations in the base of which can be factors external to the environment and nutrition. Recently, the author emphasizes the quality and style of life that constantly affect the general health of the individual but of course that their disorder can be both a cause and a consequence of the tumor. In spite of all preventive action of new information to a large extent can prevent the formation of tumors and it is suggested to avoid the corresponding food as well as special attention to the way of preparing food.
Background: The first case of COVID-19 pandemic in India was reported on 30th January 2020. As of 4th May, the Ministry of Health and Family Welfare have confirmed a total of 42,836 cases, 4762 recoveries and 1389 deaths in the country. According to ICMR1 65% of Covid patients in India were asymptomatic and 31% were symptomatic. Most of the asymptomatic cases, clearance of SARS-COV-2 RNA occur within two weeks. We report a confirmed case of COVID-19 positive asymptomatic patient whose nasopharyngeal swab test of SARS-COV-2 RNA shows persistent positivity for 40 days. This case shows the significance of active surveillance of SARS-COV-2 RNA for infectivity assessment.
Introduction: H1N1 Influenza is a contagious disease, often amounting to epidemics globally. Severe cases require ventilatory support as a life saving measure. The role of Non-Invasive Ventilation (NIV) as an alternative to invasive ventilation in these patients is increasing. In this study, we aim to study the clinical profile and outcome of patients on NIV support at a tertiary care center in India. Methods and design: In this retrospective study, 108 RTPCR confirmed H1N1 positive patients required NIV at a tertiary care center over a period of ten years (2009-2019). Data was collected according to a standardized proforma which included parameters like demographics, clinical features, examination findings, comorbidities, X-ray and laboratory reports. Subsequently patients were classified into two groups – those who recovered purely on non-invasive mode of ventilation and those who were shifted to the invasive mode. Chi-square test and Mann Whitney U test were used for qualitative and quantitative data respectively. A p-value of less than 0.05 was considered significant. Results: From a total of 528 hospitalized patients with H1N1 Influenza, 108 patients were subjected to non-invasive ventilation (NIV) and 22 (20.04%) of them were subsequently shifted to invasive ventilation. Co-morbidities were present in 52.8% (57/108) of the cases, most common being hypertension, followed by pregnancy. A higher pulse rate, lower respiratory rate, lower oxygen saturation along with a high median SGOT, ALP and serum bicarbonate levels were significantly associated with the patients being shifted from NIV to invasive ventilation. Conclusion: NIV was effective in preventing invasive ventilation in 86 (79.06%) of the 108 patients with H1N1 infection, while 22 (20.04%) patients still required intubation despite NIV. Hence, NIV can be considered to be used as an alternative to invasive ventilation in eligible patients with H1N1 influenza.
Sharp syndrome is the association in a patient of symptoms identical to at least two connective tissue diseases. It is rare in black Africans. It is characterized by a clinical polymorphism that is often the cause of diagnostic delay. Sharp syndrome is associated with the presence in the blood of antinuclear antibodies with speckled fluorescence whose antigen corresponds to a ribonucleoprotein. The diagnosis is based on the use of diagnostic criteria. We report a case of Sharp syndrome in a 39-year-old patient, whose diagnosis was raised on the basis of diagnostic criteria of Alarcon-Segovia and confirmed by those of the Japanese Ministry of Health and Welfare.
Objectives: To know about DMARDs (Disease modifying anti rheumatic drugs) used by Sudanese rheumatoid arthritis patients, the type mostly used, single or combined and to assess functional disability by health assessment questionnaire (HAQ) and disease activity by clinical disease activity index (CDAI) with each type used and the time of initiation of DMARDs therapy from the diagnosis, also to see the effect of combined therapy on functional disability and disease activity. Materials and Methods: This was descriptive cross sectional study hospital based of 100 patients diagnosed as RA by the American College of Rheumatology (ACR-EURAL 2010) criteria attending different rheumatology referred clinics from Nov 2014to Jan 2015 patients were interviewed and asked about their DMARDs which type is used and when it started from the time of diagnosis then HAQ is filled and CDAI is calculated. Results: We had analyzed 100 patients the type of their DMARD, HAQ, CDAI the time of initiation of DMARDs with the diagnosis effect on HAQ and CDAI, also the effect of combined therapy on HAQ and CDAI. We found that the age between 36-45 were mostly affected and that 95% was female. 71% were using Hydroxychloroqine (HCQ), 49% Methotrexate (MTX), 6% Leflounimide (LEFLU), 2% Sulphasalzine and 3% Azathioprine (AZA). Most patients showed minimal HAQ (69.0%) score, 64% of the study population start DMARD at the time of diagnosis. About 36% used combined MTX and HCQ. Low CDAI was the most common in patients taking MTX and HCQ, also the most common score of HAQ in them was minimal score. There is no significant difference (P value 0.23) between early initiation of DMARDs and disease activity, also the difference was not significant between the time of initiation of DMARDs and HAQ score (P 0.036). There is significant difference between the use of combined DMARDs and CDAI and HAQ score (P 0.001, P 0.004) respectively. Conclusion: The most commonly used DMARDs are HCQ and MTX, Combination therapy is not widely used in the study patient, Most of the study patients show minimal functional disability assessed by HAQ. MTX and HCQ affect disease activity and functional disability almost in the same manner, patients in the study using MTX and HCQ show minimal score using HAQ, small percentage show remission and no remission with other type of DMARDs. Early initiation of DMARDs doesn’t affect functional disability and disease activity. While combination therapy of DMARDs affect both disease activity assessed by CDAI and functional disability assed by HAQ score.
Introduction: Subacute granulomatous thyroiditis or subacute thyroiditis (ST) is characterized by neck pain or neck tenderness and physical examination usually shows diffuse enlargement and tenderness of the thyroid gland. Its etiology often involves a viral infection and ST manifestations occur during the recovery phase of this infection. In this study, we conducted a retrospective data review of 24 patients diagnosed with ST who were followed at our clinic. Patients and Results: Twenty-four patients (18 females, 6 males) with a mean age (±SD) of 41±10 years (min-max: 33-71) were followed. There was no significant age difference between males and females. Laboratory findings were as follows: mean sT4 value 2.7±1.5 ng/dL, sT3 5.5±3.3 pg/ml, TSH 0.2 ±0.4 mlU/mL, erythrocyte sedimentation rate (ESR) 82±27 mm/h, C-reactive protein (CRP) 56.4±36.5 mg/L, average leukocyte count 8762±2496/ mm3, absolute neutrophil count 5940±2390/ mm3. One patient had elevated anti-thyroid peroxidase (Anti-TPO) and four patients had elevated anti-thyroglobulin (Anti-Tg) antibody levels. The mean time from the onset of an upper respiratory tract infection until ST diagnosis was 39±28 days (min-max: 7-90), the mean duration of follow-up was 200 ±125 days (min-max: 30-370) and the mean duration of clinical manifestations of ST was 130±38 days (min-max: 65-195). Following a ST episode, 19 patients were euthyroid and 3 patients were hypothyroid. The outcome was unknown in 2 patients. Conclusion: ST affects daily life performance adversely due to symptoms of severe neck pain and difficulty swallowing. As can be seen in the case of our patients, the diagnosis of ST is rather difficult unless it is actively sought and on average, it takes 39 days to reach a definite diagnosis. Thus, ST should be considered in the presence of unexplained neck pain with ESR and CRP elevations.
Background: acute exacerbations are frequent during the course of chronic obstructive pulmonary disease (COPD). They are associated with increased morbidity and mortality. The aim of the study: is to characterize the patients who are hospitalized for acute exacerbation of COPD and the factors related to frequent hospitalization. Patients and Methods: observational cohort study. One hundred and one patients admitted to our hospital for acute exacerbation of COPD over one year (group I) and equal number of patients with mild COPD exacerbation not requiring hospital admission (groupII) were studied. Results: We found that 101 patients admitted with acute exacerbation of COPD accounted for 10% of all admissions to medical departments and 2% of all admissions to our hospital. Group I patients had more advanced disease, high frequency of current smoking and comorbidities, frequent use of systemic steroids and home oxygen therapy. They had significant leukocytosis with neutrophilia, and higher partial pressure of carbon dioxide in arterial blood (paCO2). Significantly lower partial pressure of oxygen in arterial blood (PaO2), low 6-minute walking distance (6MWD) and more advanced COPD assessment test (CAT) score and BODE index. Severity of acute exacerbation of COPD, hypercapnia, previous ICU admission, low body mass index (BMI), low (6MWD), low PaO2, and the presence of comorbidities are the factors associated with increased frequency of hospital admission. Conclusion: COPD patients who had severe acute exacerbation, comorbidities, hypoxemia, hypercapnia, history of previous admission to ICU, low BMI, and impaired physical activity are more likely to be admitted to hospital during acute exacerbation of COPD.
Background and Purpose: Vitamin D is fat-soluble steroids enhance intestinal uptake of calcium, iron, magnesium, and phosphate and is important for biological actions of cells in different tissues. Additionally, calcium homeostasis is associated with an increased risk of cardiovascular complications due to its vital role to play an important role in the regulation of blood pressure. The present study aims to assess subclinical LV mass and function in patients with essential hypertension and its association with vitamin D deficiency and parathormone excess. Methods: A retrospective study was carried out on 70 patients with elevated hypertension recruited from the Al-Zahraa Hospital, Faculty of Medicine (for Girls), Al-Azhar University with mean age (50.28±7.8) years. Vitamin D was measured using enzyme-linked immunosorbent assay (ELISA) technique, and parathormone was measured by chemiluminescence technique (Immulite 1000). Results: According to the level of vitamin D, the patients were divided into two groups. Thirty hypertensive patients with vitamin D deficiency as patients group (G1) and another 40 age, sex and BMI-matched hypertensive patients with normal vitamin D level as the control group (G2). Serum Ca, PTH, vitamin D has a highly significant difference among the two groups (p ≤ 0.001) without statistically significant difference for urea, serum, cholesterol, LDL, HDL, triglycerides. Conclusion: Subclinical target organ damage is significantly higher in hypertensive patients with vitamin D deficiency than hypertensive patients with normal vitamin D levels. Patients with vitamin D deficiency or excess PTH have higher LVMI, higher AMBP readings, a higher percent of non-dippers, and more impaired LV systolic function.
Background: Catheter associated urinary tract infection (CAUTI) is a urinary tract infection (UTI) where an indwelling catheter was in for more than two calendar days on the date of event (day one being the day of device placement). It is one of the most common hospital acquired infection and causes problems in hospitalized patients. Objectives: To review the overall occurrence of CAUTI, the demographic, clinical data and to determine the causative microorganisms of CAUTI in patients admitted in medical wards and intensive care unit (ICU) in KFHH secondary and tertiary hospital and to provide recommendations for prevention. Methods: This is cross-sectional prospective study of Catheter Associated Urinary Tract Infection (CAUTI) in medical wards and intensive care units. Only adult patients were included in this study. The data were collected from the patients ‘medical records. Results: About 30% of patients developed CAUTI; the majority of them were located in general wards. Although female had more CAUTI compared to male (33% versus 20%; P= 0.07) but the difference was not statistically significant. The most common isolated organisms among patients with CAUTI were: Candida yeasts (18%), E-coli, (3%) and pseudomonas (1%). Isolated multidrug resistant (MDR) organisms consisted about 10% of total isolated organism and most common isolated MDR organism is Vancomycin-Resistant Enterococci (VRE) 50% from total MDR. The most commonly used antibiotics for CAUTI in these patients were; ceftriaxone, linezolid, Carbepenem and Fluconazole. Conclusion: CAUTI was most common in patients admitted in wards than ICU. It was more common in females. Approximately one third of patients had CAUTI. Majority of patients had no urinary symptoms. Candida yeasts was the most common isolated microorganisms among patients with CAUTI.
Dubin Johnson syndrome (DJS) is an autosomal recessive disorder of bilirubin metabolism. It is a very rare diseases and is characterized by persistent and fluctuating jaundice. Jaundice is aggravated by stress, pregnancy, alcoholism, infections, etc. It can be mistaken for viral hepatitis. It carries an excellent prognosis with no adverse impact on life expectancy. Its early diagnosis will help in preventing undue exposure of procedures and treatment to the patients. Here we report a case of DJS which has very occurrence.
Background: Serum cartilage oligomeric matrix protein (COMP) is a non-collagen glycoprotein produced by the cartilage, synovium, tendon, and meniscus. COMP is a reliable factor for monitoring cartilage damage. COMP has been studied as a biological marker for diagnostic and prognostic purposes. Musculoskeletal ultrasound (MSUS) imaging technology have allowed imaging of inflamed joints in rheumatoid arthritis patients. Objective: To assess the relationship between serum COMP levels and the articular cartilage damage based on sonographic knee cartilage thickness (KCT), disease activity, and other inflammatory markers in RA patients. Patients and Methods: Ninty participants were divided into two groups. Group I: Forty-five rheumatoid arthritis patients, which were subdivided according to disease activity into mild, moderate and sever, carried out from rheumatology outpatient clinic and inpatient in the Internal Medicine Department, Al-Zahraa University Hospital, all patients were female with their age ranging from 18 to 70 years with mean ± SD was (44.4±12.03). Group II: Forty-five age and sex-matched as control were included. Serum COMP level, Anti-Cyclic Citrullinated Peptides (ACCP), Rheumatoid Factor (RF), High Sensitive C- Reactive Protein (hs-CRP), were assayed. Also, sonographic knee cartilage thickness and Disease activity score (DAS28) were measured. Results: There were a highly significant increase the COMP level in the patient groups (the median is 301, and the interquartile range is 48-7954.9) in comparison to the control group (the median is 91.3, and the interquartile range is 39-146) with a P-value of 0.000, and highly significant increase the COMP level in the patient groups according to disease activity. There was a highly significant reduction of the knee cartilage thickness regarding lateral condyle (LC), medial condyle (MC) and intercondylar notch (IN) bilaterally compared with the control group. There were highly significant negative correlations between COMP and RKCTLC, RKCTIC and LKCTIC (P= 0.000), significant negative correlations between COMP and RKCTMC (P= 0.004), LKCTMC (P= 0.01), while there was no significant correlation between COMP and LKCTLC (P= 0.07), the mean of the right side was (P= 0.09) and the mean of the left side was (P= 0.22). Also, significant positive correlations between COMP and DAS28 (P= 0.03) was found. Conclusion: COMP can be used as a diagnostic biomarker for RA, based on its significant correlations with disease activity, ACCP, and knee cartilage thickness.
Kisspeptin-54 is a neuropeptide encoded with Kiss-1 gene which signal by G protein receptors. It has an essential role in controlling reproductive axis by inducing hypothalamic gonadotropin-releasing hormone which in turn induce adenohypophyseal gonadotropins with subsequent stimulation of sex hormones and gamete development from the gonads. Aim: to investigate the effects of prolonged continuous peripheral subcutaneous injection of kisspeptin-54 by use of Alzet miniosmoticpumps on blood levels of LH, FSH, testosterone, testis weight, count and motility of sperms in adult male rats. Material and Methods: two groups of adult male rats (ten rats for each group) were used in the experiments to investigate the results of subcutaneous administration of kisspeptin-54 for 13 days using Alzet miniosmoticpumps implanted subcutaneously in the interscapular region to guarantee continuous delivery of Kisspeptin-54 throughout the study (50 nmol/day). Results: the study results showed that prolonged injection of kisspeptin-54 at a dose of 50 nmol/day for thirteen days in male rats decreased significantly blood level of LH, FSH, testosterone (P < 0.001) and testis weight, sperm count and motility (P < 0.001). Conclusion: it can be concluded that chronic, prolonged and continuous subcutaneous administration of Kisspeptin-54 may affect male fertility by causing significant decrease in testicular weight and sperm viability, count and motility through direct desensitization of hypothalamic–pituitary–gonadal axis rather than direct inhibitory effect on the gonads.
Background: Malnutrition risk is elevated amongst patients hospitalized with pneumonia; it's relevance to patient outcome has not been fully determined. The Malnutrition Universal Screening Tool (MUST) is a well validated tool for malnutrition screening in hospitalized patients. Objectives: To assess whether malnutrition is an independent risk factor associated with mortality. Methods: The study included all patients during 2008-2011, who were hospitalized in internal medicine departments because of pneumonia and underwent screening by MUST. Data were retrieved from electronic medical records and included: MUST score, Charlson Co-Morbidity (CCI) score, in-hospital mortality and five-year mortality. Results: The trial enrolled 507 patients; 219 (43%) females, mean age of 71.4 +/-17.3 years, 34.91% at risk for malnutrition. The bivariate analysis in hospital mortality was 3.38 times (CI 2-5.73, p<0.001) higher in patients with a MUST score of 2 or more than in patients with a MUST score of less than 2 (23.2% vs. 8.2% respectively). In-hospital mortality was significantly higher in patients older than 70 years of age, with a higher CCI and lower albumin levels. On multivariate analysis: age, high MUST, CCI, and low albumin were found to be significantly associated with higher mortality rates. Patients with a MUST score of 2 or more and a CCI of 1 or 2 had significantly higher five years mortality rates (p < 0.001). Conclusions: Pneumonia patients at risk for malnutrition had higher in- hospital and five years mortality rates than patients not at increased risk for malnutrition.
