Nutritional State during COPD Exacerbation: Clinical and Prognostic Implications

Abstract

Aims: To estimate the prevalence of malnutrition in chronic obstructive pulmonary disease (COPD) patients hospitalized for exacerbation and to evaluate its clinical and prognostic influence on the exacerbation. Subjects/Methods: The subjects were 78 consecutive patients with moderate-to-severe COPD who were admitted to hospital with a diagnosis of exacerbation. Nutritional status was assessed by means of body mass index (BMI), bioelectric impedance analysis and levels of plasmatic albumin. Previous spirometry, 6-min walk test, severity of the exacerbation, days of hospitalization and readmission in the following 3 months were also evaluated. Results: Malnutrition [BMI <20 or fat-free mass (FFM) index ≤16] occurred in 38% of patients, while in 40% the involuntary weight loss revealed a malnutrition risk and in 18% patients the plasmatic albumin levels were <3 g/dl. FFM was correlated with forced expiratory volume in 1 s, forced vital capacity and distance walked in 6 min. Number of days of hospitalization were related to FFM, muscle mass, BMI and albumin. The patients readmitted in the following 3 months had less FFM than the patients who were not readmitted. Conclusions: The high prevalence of malnutrition among hospitalized COPD patients is related to their lung function and exercise tolerance. Moreover, nutritional parameters during exacerbation are related to length of hospitalization and readmission.

Oxidative Stress and Nutritional Status in Chronic Obstructive Pulmonary Disease

“…Author in this study suggests the need of nutritional support during COPD [19]. Similarly, a study by Giron et al, reported malnutrition (BMI < 20 kg/m 2 ) in 38% and 40% under the risk of malnutrition among COPD cases [21]. Our study and few other studies shows that malnutrition and risk of malnutrition can be present even in normal BMI among COPD cases [19,22].…”

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

“…Numerous studies, however, reported on the association between nutritional status and healthcare utilisation, focusing on patients hospitalised for a COPD exacerbation or predictors thereof. The studies showed that being undernourished in COPD is likely to be associated with longer in-patient hospital stays [107,108], a higher probability of being readmitted [62,109] and an increase in healthcare utilisation [110] in comparison with normally nourished patients. Three randomised controlled trials in COPD investigated the effects of nutritional supplementation on healthcare utilisation and/or costs [65,76,111].…”

Effect of exacerbation frequency on body composition and serum ghrelin and adiponectin concentrations in patients with chronic obstructive pulmonary disease

“…Studies in patients hospitalized because of COPD exacerbation reported the incidence of cachexia to be as high as 38%. 32 Patients with a lower BMI had a greater lung function decline, higher degree of hyperinflation, and higher serum C-reactive protein levels. 33 In ambulatory patients with exacerbations, no correlations between BMI and exacerbation severity and between the administered treatment and treatment outcome were noted.…”