Nutritional Status of Chronic Obstructive Pulmonary Disease Patients Admitted in Hospital With Acute Exacerbation

Abstract

BackgroundPatients with Chronic Obstructive Pulmonary Disease (COPD) are frequently hospitalized with an acute exacerbation. Patients with COPD often lose weight. Consequently, deterioration in nutritional status (loss of lean body mass) is a likely repercussion of acute exacerbation in hospitalized COPD patients. The study was carried out to assess the nutritional status of COPD patients with acute exacerbation, during the period of hospital admission, and to evaluate the relationships between the nutritional indices and the pulmonary function parameters.MethodsA cross sectional observation study constituting 83 COPD patients consecutively hospitalized with acute exacerbation on accrual during a period of one year. Lung function was measured by routine spirometry. Nutritional status was assessed by the measurement of anthropometric parameters. Hospital outcome was also assessed. Statistical analysis was performed using SPSS version 16.0 Independent t-tests and Pearsons correlation coefficient was used.ResultsMean body weight was 50.03 ± 9.23 kg. Subjects had approximately 5 kg weight loss in previous six months. All the subjects had low BMI (19.38 ± 3.10) and MUAC (21.18 ± 2.31) that was significantly below the predicted levels. The correlation between body weight and FEV1/FVC% was good (r = 0.648, p = 0.003). BMI was negatively correlated (r = - 0.0103, p= 0.03) with duration of hospital stay.ConclusionsThe high prevalence of malnutrition among hospitalized COPD patients with acute exacerbation is related to their lung function and hospital outcome such as duration of hospital stay.KeywordsNutritional status; COPD; Acute exacerbation; Hospitalization

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].…”

Effects of oral nutritional supplementation in the management of malnutrition in hospital and post‐hospital discharged patients in India: a randomised, open‐label, controlled trial

“…Adult malnutrition is a significant health problem in India. The prevalence of malnutrition ranges from 20% to 60% in hospitalised patients (Chauhan et al ., ; Shirodkar & Mohandas, ; Gupta et al ., ; Karmakar et al ., ) and a similar magnitude of malnutrition has been reported in community‐dwelling adults (Arlappa et al ., ; Bose et al ., ; Das & Bose, ). Malnutrition leads to negative consequences for patients and economic burden for health care facilities (Amaral et al ., ; Loser, ; Barker et al ., ; Guest et al ., ), both of which add to the overall healthcare costs from malnutrition‐related diseases within India.…”

Chronic Obstructive Pulmonary Disease and its Non-Smoking Risk Factors in India

“…For instance, a hospital based study found that 83% of COPD patients were found to have BMI < 18 kg/ m 2 in the city of Luknow in North India ( 128 ). However, the loss of body weight can also be a consequence rather than a risk factor of progression of the disease as BMI was found to be negatively correlated with duration of hospital stay (r = -0.0103, p = 0.03) ( 128 ). Th e positive correlation between oxidative stress and BMI in COPD status and predicted % of FEV 1 has also been reported.…”