This study aimed to evaluate the association between metabolic syndrome (MetS) and clinical outcomes in elderly patients hospitalized with community-acquired pneumonia (CAP). A retrospective cohort study was conducted on 712 elderly patients (aged ≥ 65 years) admitted with CAP to a tertiary hospital between 2018 and 2022. Patients were stratified into two groups based on MetS status (MetS group vs. non-MetS group). The primary outcome was 90-day all-cause mortality. Propensity score matching (PSM) was applied to balance baseline characteristics. Multivariate Cox regression and logistic regression analyses were performed to assess associations, adjusting for confounders. After propensity score matching, 336 patients (168 MetS and 168 non-MetS) were included in the final analysis. The MetS group had a significantly higher 90-day mortality rate compared to the non-MetS group (29.8% vs. 11.9%, p < 0.01). Multivariate Cox regression analysis demonstrated that MetS was independently associated with a 1.98-fold increased risk of mortality (95% CI: 1.08–3.63; p = 0.03). A clear dose-response relationship was observed, with each additional MetS component increasing mortality risk by 1.46-fold (95% CI: 1.11–2.16; p < 0.01). MetS is an independent predictor of worse short-term outcomes in elderly CAP patients, including higher mortality and longer hospital stays. Early recognition and management of MetS may improve prognosis in this high-risk population.
Tang et al. (Tue,) studied this question.