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 <or=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.