Non-alcoholic fatty liver disease and 30-day all-cause mortality in adult patients with community-acquired pneumonia

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a common and serious form of chronic liver disease. Risk factors of NAFLD include obesity and type 2 diabetes which are associated with infections. Aim We aimed to determine the association of NAFLD with 30-day all-cause mortality in adult patients with community-acquired pneumonia (CAP). Methods A retrospective cohort study on hospitalized patients with CAP that was conducted during a period of 4 years. We included patients aged ≥18 years with CAP who underwent abdominal ultrasonography. We compared between patients with and without NAFLD in term of age, gender, body mass index (BMI), comorbidities, CURB-65, pneumonia severity index (PSI), liver enzymes, C-reactive protein (CRP) and 30-day all-cause mortality. We used fibrosis score to distinguish between patients with NAFLD who have advanced fibrosis (F3-F4) and do not have (F0-F2). Results A total of 561 patients were included in this study. The overall prevalence of NAFLD was 200/561 (35.6%). Significant differences were found between the groups with and without NAFLD in term of BMI, CURB-65, ALT, GGT and CRP. The 30-day all-cause mortality rate was 9.8% (55/561). Among the NAFLD group 34/200 (17%) subjects died vs. 21/361 (5.82%) among patients without NAFLD, P 2 (1.52; 1.25–1.70, P = 0.03) were associated with 30-day all-cause mortality among patients with CAP. Conclusions NAFLD was associated with 30-day all-cause mortality in patients with CAP. This association was more significant in patients with advanced hepatic fibrosis.