SESSION TITLE: COPD Diagnosis and Evaluation Posters I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a disease of lung airways and parenchyma defined by airflow limitation due to inflammatory response to noxious fumes and gases. Systemic inflammation seen in patients with COPD is characterized by systemic oxidative stress that is associated with abnormalities like weight loss. We hypothesized that patients with higher grades of COPD will have greater loss of bodyweight. So, we evaluated the variation in body mass index (BMI) in different grades of COPD.
METHODS: This cross-sectional study was conducted in a teaching hospital in rural Nepal. Study duration was three months. Patients visiting medicine outpatient department or admitted in ward with the diagnosis of COPD were included and those with pleural effusion, bronchiectasis, lung abscess and lung cancer were excluded. Patients underwent spirometry evaluation by hand held spirometer (Helios 401, Recorders and Medicare Systems) and diagnosis of COPD was made when ratio of post bronchodilator forced expiratory volume at 1 second (FEV1) to forced vital capacity (FVC) was less than 70%. Patients with COPD were graded on Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades based on post bronchodilator FEV1. BMI was measured and was compared among grades of COPD.
RESULTS: Out of 48 patients screened, 14 were excluded and 34 were included in the study.The mean age was 66 years and 70% were females. None of the patients were in GOLD grade 4. Number of patients in Grade 1 was eight (23.5%), in Grade 2 was 20(58.8%) and in Grade 3 was six (17.6%). The difference in age of the patients (p=0.375) and in duration of illness before presentation (p=0.103) was not different among the groups. The BMI of patients in grade 1 was 21.6kg/m2, grade 2 was 20.8kg/m2 and grade 3 was 16.3kg/m2. The decline in BMI seen in higher grades of COPD was statistically significant (p=0.001).
CONCLUSIONS: In this first study from rural western region of Nepal, we have looked for the presence of poor nutrition in patients with COPD by calculating BMI. We found that patients with higher grades of COPD have lower BMI and thus show that advanced COPD is associated with greater degree of weight loss.
CLINICAL IMPLICATIONS: Malnourished patients of COPD have increased risk of in-hospital deaths and of readmission. This cross sectional study provides data on the nutritional status of patients suffering with COPD in rural Nepal.This study also provokes further studies in the area of nutritional intervention in patients of COPD.
DISCLOSURE: The following authors have nothing to disclose: Mukesh Paudel, Bishal Chhetri, Sahadeb Dhungana, Shamsuddin Amin
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