title: The prognostic significance of nutritional status using malnutrition universal screening tool in patients with pulmonary tuberculosis.
abstract: BACKGROUND
  Malnutrition is frequently observed in patients with pulmonary tuberculosis (TB). The present study aimed to examine the relationship between nutritional status using Malnutrition Universal Screening Tool (MUST) and the mortality of patients with pulmonary TB.
  
  
  METHODS
  Fifty-seven patients with pulmonary TB were analyzed. Nutrition assessment was carried out using MUST. The Cox proportional hazard model was applied to assess the ability of MUST to predict prognosis. Receiver operating characteristic curve analysis was used to assess MUST score as a prognostic indicator in pulmonary TB patients. To obtain optimal cut-off values for MUST score for prognostic assessment in TB patients, we used the maximum Youden Index.
  
  
  RESULTS
  For predicting the risk of mortality, the optimal cut-off value for MUST score was 3.5. Univariate and multivariate analyses identified age and MUST score ≥ 4 as significant independent prognostic factors for survival. The patients with MUST score ≤ 3 had a median survival of 481 days (95% CI: 453 to 510) and that for the patients with MUST score ≥ 4 was 304 days (95% CI: 214 to 394); the difference was statistically significant (P = 0.001).
  
  
  CONCLUSIONS
  MUST appears to be a reliable tool for nutritional risk assessment of patients with pulmonary TB. In addition, MUST may be a useful prognostic indicator of survival in patients with pulmonary TB.
authors.affiliation: Department of Internal Medicine, Hanna Hospital, 1-1-31 Terakawa, Daito, Osaka 574-0014, Japan. smiyata61@hotmail.com
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyata
authors.forename: Mikio
authors.initials: M
authors.lastname: Tanaka
authors.forename: Daizo
authors.initials: D
authors.lastname: Ihaku
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000503:physiopathology*; D055815:Young Adult
references.citation: Nutr Rev. 2003 Mar;61(3):81-90
references.pmid: 12723640
references.citation: Nutr Rev. 2007 May;65(5):181-217
references.pmid: 17566547
references.citation: Eur J Respir Dis. 1987 Nov;71(5):341-4
references.pmid: 3443156
references.citation: Nutr Clin Pract. 2011 Feb;26(1):55-60
references.pmid: 21266698
references.citation: Eur J Clin Nutr. 1988 Apr;42(4):363-6
references.pmid: 3396528
references.citation: Lancet. 2011 Jan 15;377(9761):242-50
references.pmid: 21215445
references.citation: N Engl J Med. 2004 May 13;350(20):2060-7
references.pmid: 15141044
references.citation: Kekkaku. 2010 May;85(5):495-8
references.pmid: 20560404
references.citation: Eur J Clin Nutr. 1989 Feb;43(2):117-28
references.pmid: 2707215
references.citation: Am J Clin Nutr. 2003 Feb;77(2):392-8
references.pmid: 12540399
references.citation: BMC Neurol. 2010 Dec 30;10:124
references.pmid: 21192784
references.citation: Int J Tuberc Lung Dis. 2006 Jan;10(1):80-6
references.pmid: 16466042
references.citation: Lancet. 2000 Feb 19;355(9204):618-21
references.pmid: 10696983
references.citation: Br J Nutr. 2006 Feb;95(2):325-30
references.pmid: 16469149
references.citation: J Allergy Clin Immunol. 2005 May;115(5):911-9; quiz 920
references.pmid: 15867843
references.citation: Clin Microbiol Rev. 2005 Jul;18(3):446-64
references.pmid: 16020684
references.citation: Thorax. 1985 Mar;40(3):187-90
references.pmid: 3872485
references.citation: J Hum Nutr Diet. 2008 Feb;21(1):3-9; quiz 10-2
references.pmid: 18184388
references.citation: PLoS One. 2011;6(9):e25315
references.pmid: 21980423
references.citation: J Clin Endocrinol Metab. 2005 Aug;90(8):4771-6
references.pmid: 15928249
references.citation: Int Immunol. 2005 Nov;17(11):1399-408
references.pmid: 16141243