The Impact of Nonalcoholic Fatty Liver Disease on Severe Community-Acquired Pneumonia Outcomes

Scientific paper - Original scientific paper

• Author: Branimir Gjurašin
• Author: Mia Jeličić
• Author: Marko Kutleša
• Author: Neven Papić
• Author's institution: University of Zagreb; School of Medicine; (Department of Infectious Diseases)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract (english)

Community-acquired pneumonia (CAP) is one of the leading causes of morbidity and mortality, while nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. NAFLD is associated with systemic changes in immune response, possibly linked to CAP severity. However, the impact of NAFLD on CAP outcomes has not been determined. The aim of this study was to evaluate clinical course, complications and outcomes of severe CAP requiring ICU treatment in patients with NAFLD in the pre-COVID-19 era. A retrospective cohort study included 138 consecutively hospitalized adult patients with severe CAP admitted to the ICU during a 4-year period: 80 patients with NAFLD and 58 controls. Patients with NAFLD more frequently presented with ARDS (68.7% vs. 43.1%), and required invasive mechanical ventilation (86.2% vs. 63.8%), respiratory ECMO (50% vs. 24.1%), and continuous renal replacement therapy (62.5% vs. 29.3%). Mortality was significantly higher in the NAFLD group (50% vs. 20.7%), and the time from hospital admission to death was significantly shorter. In survival analysis, NAFLD (HR 2.21, 95%CI 1.03–5.06) was associated with mortality independently of other components of metabolic syndrome. In conclusion, our study identified NAFLD as an independent predictor of mortality in patients with severe CAP.

• Keywords (english): ARDS; CAP; ECMO; NAFLD; acute respiratory distress syndrome; community-acquired pneumonia; influenza; metabolic syndrome; nonalcoholic fatty liver disease
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Life
• Numbering: vol. 13, no. 1, 36
• e-ISSN: 2075-1729
• DOI: https://doi.org/10.3390/life13010036
• URN:NBN: urn:nbn:hr:105:827622
• Publication: 2022-12-23
• Project: Number: UIP-2019-04-7194; Title (croatian): Uloga imunih semaforina u nealkoholnoj masnoj bolesti jetre i sepsi; Title (english): The role of immune semaphorins in NAFLD and sepsis; Acronym: SepsisFAT; Leader: Neven Papić; Jurisdiction: Croatia; Funding stream: UIP
• Document URL: https://www.mdpi.com/2075-1729/13/1/36
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-01-23 09:40:38