Diagnostic Value of Bilateral Pectoralis Major Total Cross-Sectional Area in Patients with AECOPD Complicated by...

Patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) often suffer from malnutrition, and traditional assessment methods struggle to fully capture muscle loss. The value of total pectoralis major area (tPMA) measured by CT remains to be determined. This study aimed to investigate the relationship between tPMA and malnutrition in patients with AECOPD and its diagnostic value.

A total of 123 patients with AECOPD were enrolled (35 in the malnutrition group and 88 in the non-malnutrition group). Clinical and imaging parameters were compared between the two groups. Logistic regression analysis was used to assess the independent association between tPMA and malnutrition, and ROC curves were employed to evaluate its diagnostic performance when used alone or in combination with albumin (ALB) or total protein (TP). Spearman correlation analysis was used to examine the relationship between tPMA and other nutritional and disease severity indicators.

tPMA levels were significantly lower in the malnourished group than in the non-malnourished group (P < 0.01). tPMA was a protective factor against malnutrition in patients with AECOPD (OR = 0.998, P < 0.001); this association remained statistically significant after adjusting for confounding factors (P < 0.05). The AUC of tPMA for the standalone diagnosis of malnutrition was 0.770; when combined with ALB or TP, the AUC increased to 0.901 and 0.916, respectively (P < 0.05). tPMA was positively correlated with nutritional indicators and negatively correlated with the NRS2002 and CAT (P < 0.05).

tPMA is an independent associated factor against malnutrition in patients with AECOPD; when combined with ALB or TP, it significantly improves diagnostic performance and can serve as an objective adjunctive assessment indicator.