Nutritional Status in Patients Hospitalized with Acute Exacerbation of COPD
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Abstract
Introduction: Malnutrition is a common comorbidity in COPD and associated with increased incidences of complications during hospitalization due to acute exacerbation (AE).
Outcome: Primary outcome was access nutritional status in COPD patients who were hospitalized due to AE. Secondary outcome was access associated between malnutrition and treatment outcomes (length of stay, hospital mortality and complications)
Sample: COPD patients who diagnosis COPD with AE and admit at Vajira Hospital, Navamindhradhiraj University from April 1, 2018 to February 28, 2019.
Method: Prospective cohort study in COPD patients who were hospitalized due to AE to determine prevalence and to compare outcomes between patients with and without malnutrition. The anthropometric indices and biochemical data were recorded for by using Multiparameter Nutritional Index(NI). Patients were classified into malnutrition(NI≥5) and non-malnutrition groups(NI<5) using a reference normal value from NHANES.
Result: We included 56 COPD patients, The prevalence of malnutrition was 82.1% (n=46). When comparison between malnutrition and no malnutrition group we found in malnutrition group has significant normal ideal body weight than no malnutrition group (p<0.001). And in no malnutrition group tends to has overweight up to 75%. In outcome of treatment no significant in length of stay. In malnutrition group has mean length of stay 12.72±9.90 day. And in no malnutrition group has mean length of stay 10.70±7.59 day (p = 0.548). COPD patients with malnutrition showed significantly more complications during hospitalization due to AE than those without malnutrition 89.1% and 60% respectively (p-value 0.044). The last we found in malnutrition group has mortality 13% when in no malnutrition group has mortality 0% but insignificant in statistic.
Conclusion: The prevalence of malnutrition in patients with COPD in Thailand is very high and is significantly associated with more complications during AE. Nutritional assessment and intervention in this group is very important and should be considered.
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References
Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease 2017 Report. Respirology 2017; 22(3): 575–601.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2163-96.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2095–128.
Mathers CD. Chronic obstructive pulmonary disease WHO [Internet]. 2013 [cited 2017 August 5]. Available from: https://www.Chronic obstructive pulmonary disease (COPD) (who.int)
Malnutrition [Internet]. 2017 [cited 2017 August 5]. Available from: https://th.wikipedia.org/wiki
Anderson L, Banner J, Bostock B, Bowden M, Collins P, Holdoway A, et al. Managing Malnutrition in COPD [Internet]. 2016 [cited 2016 June 21]. Available from: https://www.malnutritionpathway.co.uk
Hunter AM, Carey MA, Larsh HW. The nutritional status of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 1981;124(4):376–81.
Laaban JP, Kouchakji B, Dore MF, Orvoen-Frija E, Rochemaure J, David P. Nutritional Status of Patients with Chronic Obstructive Pulmonary Diseaseand Acute Respiratory Failure. Chest journal 1993; 103(5): 1362-68.
Gupta B, Kanta S, Mishrab R, Vermaa S. Nutritional Status of Chronic Obstructive Pulmonary Disease Patients Admitted in Hospital With Acute Exacerbation. J Clin Med Res 2010;2(2):68-74.
Mathew JT, Veena GF, Kurpad AV, D’Souza GA. Nutritional status Predicts Outcome in Patients Hospitalised With Exacerbation Of COPD Lung India 2006; 23(4): 143-46.
Pattarakantakul P, Donlao J. Effects of Nutritional Promotion Program for Chronic Obstructive Pulmonary Disease Patients with Malnutrition. Nursing journal of the ministry of public health 2017; 27 (2): 69-79.
MingHoong J, Ferguson M, Hukins C, Collins PF. Economic and operational burden associated with malnutrition in chronic obstructive pulmonary disease. Clinical Nutrition 2017;36(4):1105-9.