The impact of nutritional status, comorbidities, and frailty on short-term outcomes in elderly patients with community-acquired pneumonia: A prospective observational study at a tertiary hospital in the South of Vietnam

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Background Community-acquired pneumonia (CAP) remains a leading cause of mortality, particularly among the elderly. Frailty is common in this population and is associated with adverse outcomes, including mortality and readmission. However, limited research has examined its role in predicting short-term clinical outcomes, particularly in relation to nutritional status and comorbidities among elderly pneumonia patients in Vietnam. Methods A prospective cohort study included 246 participants aged 60 years or older hospitalized with CAP at Thong Nhat Hospital between March and September 2023. Frailty was assessed using the Clinical Frailty Scale (CFS), nutritional status using the Mini Nutritional Assessment–Short Form (MNA-SF), and comorbid burden using the Charlson Comorbidity Index (CCI). Cox proportional hazards regression models were applied to evaluate associations with 30-day and 90-day mortality and hospital readmission. Results In the univariate analysis, frailty was significantly associated with 90-day mortality and 90-day readmission, but not with 30-day mortality or 30-day readmission. After multivariable adjustment, frailty was no longer independently associated with either 90-day outcome. In contrast, lower MNA-SF scores and higher CCI scores remained independently associated with 30-day mortality as well as 90-day mortality and 90-day readmission after adjustment for age, sex, BMI, and CAP severity. No independent predictors of 30-day readmission were identified. Conclusion Frailty was not independently associated with short-term post-discharge outcomes after multivariable adjustment. Lower MNA-SF scores and higher CCI scores were independently associated with 30-day mortality, 90-day mortality, and 90-day readmission, but not with 30-day readmission. These findings support comprehensive assessment of nutritional status and comorbidity burden for post-discharge risk stratification in older adults hospitalized with CAP.