Prognostic Value of Computed Tomography-Measured Visceral Adipose Tissue in Patients with Pulmonary Infection Caused by Carbapenem-Resistant Klebsiella pneumoniae

Piaopiao Ying; Jiajing Chen; Yinchai Ye; Chang Xu; Jianzhong Ye

doi:10.2147/IDR.S479302

Prognostic Value of Computed Tomography-Measured Visceral Adipose Tissue in Patients with Pulmonary Infection Caused by Carbapenem-Resistant Klebsiella pneumoniae

Infect Drug Resist. 2024 Oct 29:17:4741-4752. doi: 10.2147/IDR.S479302. eCollection 2024.

Authors

Piaopiao Ying¹, Jiajing Chen², Yinchai Ye³, Chang Xu⁴, Jianzhong Ye⁵

Affiliations

¹ Department of General Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, People's Republic of China.
² Department of Nephrology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Taizhou, People's Republic of China.
³ Department of General Medicine, The Health Center of Eryuan Town, Wenzhou, People's Republic of China.
⁴ Department of Intensive Care Medicine, Ningbo No. 2 hospital, Ningbo, People's Republic of China.
⁵ Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.

Abstract

Objective: This study aimed to investigate the correlation between computed tomography (CT) derived body composition and 30-day mortality in patients with pulmonary infections caused by carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae).

Methods: A total of 89 eligible participants from a tertiary teaching hospital, enrolled between January 1, 2016, and December 31, 2020, were included in the study. We analyzed the relationship between visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), total adipose tissue (TAT), and skeletal muscle (SM) and 30-day mortality in patients infected with carbapenem-resistant K. pneumoniae (CRKP) in the pulmonary region. Furthermore, we established Cox regression models and a personalized nomogram model to predict the probability of 30-day mortality in these infected patients.

Results: Individuals with high VAT exhibited a higher likelihood of 30-day all-cause mortality (P<0.01) and 30-day mortality due to CRKP infection (P<0.01) compared to those with low VAT. Similar results were observed for TAT. After adjusting for significant comorbidities and other clinical characteristics, Cox regression analysis revealed that male gender (adjusted HR = 4.37; 95% CI = 0.96-19.92, P=0.06), vasopressor use (adjusted HR = 3.65; 95% CI = 1.04-12.85, P=0.04), and VAT (adjusted HR = 1.16; 95% CI = 1.01-1.34, P=0.03) were independent risk factors for 30-day all-cause mortality among these infectious patients.

Conclusion: The study results highlight the significant prognostic value of CT-quantified visceral adipose tissue in patients with CRKP pulmonary infection. Individuals with high VAT are more prone to mortality within 30 days compared to those with low VAT.

Keywords: body composition; carbapenem-resistant Klebsiella pneumoniae; mortality; pulmonary infection; visceral adipose tissue.

Grants and funding

This work was supported by the National Natural Science Foundation of China (grant number 82102457), the Zhejiang Provincial Natural Science Foundation of China (grant number LQ22H200004), the Zhejiang Provincial Science and Technology Plan Project of China (grant number 2023RC046), the Planned Science and Technology Project of Wenzhou (grant number Y20210110) and Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province (grant number 2022E10022).