PROTEIN-ENERGY MALNUTRITION IS ASSOCIATED WITH HIGHER MORTALITY AND ADVERSE CLINICAL OUTCOMES IN PATIENTS WITH COPD AND CO-EXISTING OSA

Abstract

TYPE: Abstract TOPIC: Sleep Disorders PURPOSE: Protein-Energy Malnutrition (PEM) worsens outcomes for patients with chronic obstructive pulmonary disease(COPD). To our knowledge, the impact of PEM on COPD with Co-existing Obstructive sleep apnea(OSA) is not well known. Therefore, our study sought to measure the effect of PEM on clinical outcomes in patients with COPD and OSA. METHODS: We queried the National Inpatient Sample (NIS) between 2017 and 2018. We searched the NIS for adult patients hospitalized with COPD & co-existing OSA as a principal diagnosis with and without PEM as a secondary diagnosis using ICD-10codes. The primary outcome was inpatient mortality, while secondary outcomes were length of stay (LOS), Hospital Charges (HC), respiratory failure (RF), and intubation. Multivariable logistic and Poisson regression model was used for clinical outcomes. RESULTS: A total of 126,575 patients with COPD and Co-existing OSA were admitted,and 1.66% had PEM. PEM vs No PEM cohorts include;(Mean Age of 67.8 years[CI 68.8 - 68.76] vs 65.2 years[CI 65.0 - 65.3]), Males(44% vs 45.5%), Whites(75.7% vs 72.7%), Black(14.9% vs 19.1%), & Hispanic (5.9% vs 5.5%). PEM in patients hospitalized with COPD with OSA had a significant increase in inpatient mortality (adjusted odds ratio [aOR] 2.6 [95% CI 1.30-5.2, p=0.007]), RF(aOR 2.24 [CI 1.78-2.82]), and intubation(aOR 5.18 [CI 1.98-13.5]). PEM also resulted in higher hospital charges and longer LOS. (Table 1). CONCLUSIONS: PEM was associated with worsening inpatient clinical outcomes in patients hospitalized with COPD and concomitant OSA. CLINICAL IMPLICATIONS: Clinicians should be aware of how PEM may impact the outcomes of patients with COPD and concomitant OSA. DISCLOSURE: Nothing to declare. KEYWORD: PROTEIN-ENERGY MALNUTRITION, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, OBSTRUCTIVE SLEEP APNEA