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The Nutritional Status of Chronic Obstructive Pulmonary Disease Exacerbators
Carina Rôlo Silvestre1, Tiago Dias Domingues2, Luís Mateus1
1Serviço de Pneumologia, Centro Hospitalar do Oeste, Torres Vedras, Lisbon, Portugal.
Introduction:
Malnutrition is underdiagnosed in chronic obstructive pulmonary disease.
Objectives:
This study aimed to evaluate the nutritional status of COPD patients and the link between dyspnea and nutritional status.
Methods:
This longitudinal observational study included patients hospitalized with exacerbated COPD. Nutritional status was assessed using Nutrition Risk Screening 2002, anthropometric, and biochemical assessments, in the first 48 hours of hospitalization.
Results:
Thirty patients were evaluated. According to the Nutrition Risk Screening 2002, half of the patients were at increased risk of malnutrition. 36.7% were classified as malnourished if we only considered the body mass index. From the evaluation of the tricipital skin fold, 69.0% were classified as malnourished, with 48.3% having severe malnutrition. According to the serum albumin level, 29.6% had malnutrition criteria. A significant association between dyspnea and increasing age (p=0.037) was found. There was a strong association between the fold classification and the degrees of severity of dyspnea (Fisher exact test: 13.60, p=0.001, V Cramer = 0.826). Most patients were malnourished and had higher grades of dyspnea. Tricipital skinfold reflects subcutaneous adipose tissue; this anthropometric measurement seems to be a good method to classify the nutritional status of COPD patients. It classified the biggest portion of patients as malnourished.
Conclusion:
The number of patients classified as malnourished changed with the method under analysis. The tricipital skin fold parameter was strongly associated with the dyspnea score. Most patients had adipose tissue and muscular mass depletion.
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