Prevalence of sarcopenia and malnutrition during acute exacerbation of COPD and after 6 months recovery.

Abstract

Sarcopenia defined by the association of skeletal muscle mass depletion and a decreased physical performance is underdiagnosed in chronic obstructive pulmonary disease (COPD) patients. The objective was to assess prevalence of sarcopenia and malnutrition in hospitalized COPD patients during an acute exacerbation, after 6 months follow-up and the 1-year survival. Hospitalized COPD patients were recruited for the assessment of body composition, handgrip strength, respiratory function, and maximal inspiratory and expiratory pressures (MIP and MEP), during hospitalization and 6 months later. Sarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older Adults, malnutrition was defined according to French criteria 2007. Survival data were collected 12 months after hospitalization. We analyzed data from 54 patients, aged 68 ± 9 years and BMI 26.9 ± 7.8 kg/m2, with an average FEV1 of 1.13 ± 0.49 l (45 ± 16% predicted value). Sarcopenia and malnutrition prevalence were, respectively, 48% and 52% during hospitalization, 30% and 30% after 6 months. MIP and MEP were lower in sarcopenic patients (p = 0.01 and 0.009, respectively). In multivariate analysis, skeletal muscle mass index and MIP were positively correlated at 6 months' follow-up (r = 0.40, p = 0.04). The 1-year survival rate was lower in sarcopenic patients (65 vs 86%, p = 0.03), particularly when malnutrition was associated (p = 0.02). Sarcopenia in COPD patients is highly prevalent during and after recovery of an acute exacerbation, exposing to lower survival. A multimodal management is required to treat sarcopenia and improve prognosis.