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The clinical characteristics and prognosis in chronic obstructive pulmonary disease patients with anorexia
Qing Song1,2,3,4, Dan Peng5, Ping Zhang1,2,3,4
1Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Background:
Anorexia is a common problem among patients with chronic obstructive pulmonary disease (COPD). This study aimed to analyze the clinical characteristics and prognosis of COPD patients with anorexia.
Methods:
This prospective cohort study included patients registered in the RealDTC study between May 2023 and February 2024. Demographic on COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) scores, pulmonary function, number of exacerbations, inhalation therapy, and the section of anorexia/cachexia subscale (A/CS)-12 of Functional Assessment of Anorexia/Cachexia Therapy (FAACT) scores were collected. A FAACT A/CS-12 score of ≤ 30 was used to identify patients with anorexia. All patients were followed up for one year to collect exacerbations, and mortality.
Results:
A total of 758 patients with COPD were enrolled, 132 (17.4%) of whom had anorexia. Patients with anorexia had higher age, CAT and mMRC scores, number of exacerbations, and worse pulmonary function. Logistic regression analysis showed that CAT scores of 10-19 (OR = 2.867, 95% CI = 1.423-5.773), 20-29 (OR = 6.932, 95% CI = 3.234-14.857) and ≥ 30 (OR = 67.355, 95% CI = 7.221-628.271), and number of hospitalizations ≥ 1 (OR = 2.041, 95% CI = 1.347-3.093) were independent risk factors for anorexia (p < 0.05). In addition, patients with anorexia experienced more future exacerbations, frequent exacerbations, and hospitalizations (p < 0.05). The ROC curves showed that FAACT A/CS-12 scores had a predictive capacity for future exacerbation, frequent exacerbation, and hospitalization.
Conclusions:
The COPD patients with anorexia had worse pulmonary function, higher symptoms burden, and risk of exacerbation and hospitalization.
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