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

Piaopiao Ying,1 Jiajing Chen,2 Yinchai Ye,3 Chang Xu,4 Jianzhong Ye5 1Department of General Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, People’s Republic of China; 2Department of Nephrology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Taizhou, People’s Republic of China; 3Department of General Medicine, The Health Center of Eryuan Town, Wenzhou, People’s Republic of China; 4Department of Intensive Care Medicine, Ningbo No. 2 hospital, Ningbo, People’s Republic of China; 5Department 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 ChinaCorrespondence: Chang Xu, Department of Intensive Care Medicine, Ningbo No. 2 hospital, Ningbo, 41 Xibei Street, Ningbo, 315010, People’s Republic of China, Email [email protected] Jianzhong Ye, Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou, 325000, People’s Republic of China, Email [email protected]: 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, visceral adipose tissue, pulmonary infection