Prevalence of Malnutrition in COPD Inpatients and its Relationship with Nutritional Intakes and Clinical Outcomes

Introduction: Studies suggest that 25% to 40% of Chronic Obstructive Pulmonary Disease (COPD) patients are undernourished. Poor nutritional status in COPD patients is related to increased risk of complications, hospital length of stay (LOS) and mortality. This study aims to investigate the prevalence of malnutrition risk, and to explore its relationship with the nutritional intakes, and the clinical outcomes among a group of COPD inpatients at a local acute hospital. Method: One hundred eighty records of COPD patients who have seen a dietitian during the admission period from 1 Apr 2017 to 31 Mar 2019 were retrieved. Prevalence of malnutrition risk, protein and energy intake, mortality, LOS and the 28-day emergency readmission after discharge were compared among different risk groups. Result: The prevalence of malnutrition risk among these 180 COPD patients was 77.8%. The LOS of patients with malnutrition risk was 59% longer than the low risk group (8.9 ± 11.8days vs. 5.6 ± 3.4days, p<0.05). The emergency readmission rate within 28 days was higher in the at-risk patients compared to low-risk patients (37.5% vs. 20.0%, OR=2.44, p<0.05), as was the mortality rate (5.0% vs. 0%, OR 4.55, p<0.05). Eighty-eight patients have Body Mass Index (BMI) records, 60% of them were underweight with BMI ≤ 18.5 kg/m2, in which 26% were categorized as severely underweight (BMI ≤ 16.0 kg/m2). One hundred fifty-six subjects have energy and protein intake records. The mean intakes were 839kcal and 37g respectively, meeting only 59% and 64% of their requirements. Conclusion: The prevalence of malnutrition risk is high in COPD inpatients, and such patients are more prone to have poorer clinical outcomes and nutritional status. Increased hospital LOS, higher mortality rate, higher readmission rate, and lower nutritional intakes are common in malnourished COPD inpatients. Regular nutrition assessment is therefore crucial for COPD patients at early disease stages to prevent and treat malnutrition.