Abstract
Malnutrition has a negative impact on patients with chronic pulmonary obstructive disease (COPD). The purpose of this study was to assess the prevalence of malnutrition, defined by the Global Leadership Initiative for Malnutrition (GLIM), in stable COPD patients referred to pulmonary rehabilitation, and to explore potential associations of malnutrition according to GLIM, and its components, with increased risk of mortality and hospitalizations in 2 years. In a post-hoc analysis of a prospective cohort of 200 rehabilitation patients with stable COPD, main outcome variables were hospital admissions, length of stay, and mortality during a 2-year follow-up. Covariates were malnutrition according to GLIM and its phenotypic criteria: unintentional weight loss, low body mass index (BMI), and low fat-free mass (FFM). Univariate and multivariate analysis were performed using logistic and proportional hazard Cox regression. Malnutrition according to GLIM showed 45% prevalence and was associated with increased mortality risk. Low age-related BMI and FFM were independently associated with mortality, which persisted after adjustment for age and lung function. Malnutrition and low BMI were also associated with increased risk of hospitalization. Malnutrition according to GLIM criteria was highly prevalent in rehabilitation patients with COPD and was associated with nearly 3 times greater mortality and hospitalization risk.
Highlights
Chronic obstructive pulmonary disease (COPD), a heterogeneous disease with pulmonary and extrapulmonary manifestations, is the third-highest cause of mortality worldwide, claiming 3 million lives in 2016 [1]
Given the lack of a worldwide consensus on diagnostic criteria to be applied in all clinical settings and the new evidence supporting the influence of disease and inflammation on malnutrition, the Global Leadership Initiative on Malnutrition (GLIM)
The main purpose of this study was to assess the prevalence of malnutrition, as defined by the Global Leadership Initiative for Malnutrition (GLIM), in patients with COPD
Summary
Chronic obstructive pulmonary disease (COPD), a heterogeneous disease with pulmonary and extrapulmonary manifestations, is the third-highest cause of mortality worldwide, claiming 3 million lives in 2016 [1]. It is highly associated with morbidity and disability [2] and frequently associated with concomitant diseases, including nutritional disorders [3]. COPD ranges from 20% to 45%, depending on the setting and the diagnostic methods used [9,10,11]. Given the lack of a worldwide consensus on diagnostic criteria to be applied in all clinical settings and the new evidence supporting the influence of disease and inflammation on malnutrition, the Global Leadership Initiative on Malnutrition (GLIM)
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