Malnutrition in chronic obstructive pulmonary disease (COPD) patients is more prevalent during times of exacerbation. Fat-free mass index (FFMI), calf circumference (CC), and adductor muscle pollicis thickness (AMPT) can be used to identify reduced muscle mass and have been found to be good predictors of clinical outcomes in other conditions but they have not been investigated in COPD. Therefore, this study evaluated low muscle mass as predictor of malnutrition, prolonged length of stay (LOS), and in-hospital death in COPD patients.
Prospective cohort study carried out in hospitalized patients with COPD exacerbation. Malnutrition diagnosis was performed by subjective global assessment (SGA), and muscle mass was assessed by FFMI, calculated using fat-free mass from Bioelectrical Impedance, CC, and AMPT. Clinical outcomes (LOS and in-hospital death) were collected from records.
176 patients were included (68.2±10.4 years, 56.2% women), 74.2% were classified as Global Initiative of Chronic Obstructive Lung Disease 2 or 3, and 58.2% as malnourished. The median LOS was 11 (7-19) days, and the incidence of death was 9.1%. Low FFMI, and CC predicted malnutrition (low CC; OR = 4.6; 95%CI, 2.2-9.7 and low FFMI; OR = 8.8, 95%CI, 3.7-20.8), and were associated with prolonged LOS (low CC; OR = 2.3; 95%CI, 1.1-4.6 and low FFMI; OR = 2.5, 95%CI, 1.3 – 4.8).
Simple, non-expensive, and non-invasive parameters of muscle mass – FFMI and CP – are good predictors of malnutrition and prolonged LOS in COPD patients experiencing exacerbation. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.