Predictive value of frailty and nutritional status for hospital acquired pneumonia in elderly patients undergoing vascular surgeries.

Background: Hospital acquired pneumonia (HAP) is one of the most common types of nosocomial infections, and closely related to poor prognosis. The present study intends to explore the predictive value of preoperative frailty and nutritional status for HAP in elderly patients undergoing vascular surgeries. Methods: All elderly patients who underwent vascular surgeries from June 2022 to June 2025 were retrospectively selected. Patients were divided into HAP group or non-HAP group based on the presence of HAP during the hospital stay. The frailty was assessed by using the FRAIL scale, while The nutritional status was assessed by using the Controlling Nutritional Status (CONUT) score. Results: A total of 675 elderly patients were included in the present study, of which 102 individuals were diagnosed as HAP. The proportions of smoking, general anesthesia and transfusion in HAP group were significantly higher compared with those in non-HAP group. Patients with HAP were more likely to have preoperative frailty. Significant difference in the preoperative nutritional status could also be observed between HAP group and non-HAP group. Logistic regression analysis revealed smoking, general anesthesia, frailty and moderate or severe malnutrition were independent risk factors for HAP. By using receiver operating characteristic (ROC) curve, the AUC of frailty and moderate or severe malnutrition was, respectively, 0.670 (0.606-0.734) and 0.675 (0.612-0.738). Once combined, the AUC increased up to 0.763 (0.702-0.824) with sensitivity of 0.647 and specificity of 0.838. Conclusion: HAP is a common complication among elderly patients undergoing vascular surgery. Preoperative frailty and malnutrition are independent risk factors for HAP, and have a concrete predictive efficacy. Our findings provide a basis for risk stratification and preventive measures of HAP.