SESSION TITLE: Outcomes in COPD
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Tuesday, October 27, 2015 at 02:45 PM - 04:15 PM
PURPOSE: Malnutrition is a common systemic effect of COPD that is correlated with frequent hospital visits and an independent risk factor for mortality among COPD patients. This study aims to correlate COPD exacerbation with the nutritional status of the elderly patient aged ≥ 65 years old using the BMI, anthropometric measurements, and MNA®-SF.
METHODS: A cross sectional study involving 131 elderly COPD patients at the Philippine Heart Center were studied. Nutritional status using Mini Nutritional Assessment short form (MNA®-SF), Body Mass Index, and Anthropometric measurements (Mid Arm Circumference, Calf Circumference) were measured. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD Combine Assessment Tool was used to evaluate rate of exacerbation. Nutritional Status was correlated with the risk of exacerbation using the Pearson’s product-moment correlation, and was graphically presented using scatter plot. A p-value of < 0.050 was considered significant.
RESULTS: One hundred thirty one COPD patients participated in the study. Based on MNA®-SF, subjects who have a normal nutritional status significantly have no episodes of exacerbation in a year. Those who are at risk of malnutrition, noted to have at least one episode of exacerbation per year. However, 2 or more exacerbations were observed for those who are malnourished. Scatterplot presented a positive correlation between malnutrition and risk of exacerbation. Malnourished patients are more likely to have ≥ 1 exacerbations per year (r=0.7041, p=0.000). BMI and MAC showed significantly negative correlation with risk of exacerbation respectively (r=-0.3873, p=0.000; r=-0.2555, p=0.0039). Patient with lower BMI and smaller MAC will have more exacerbations per year.
CONCLUSIONS: There is a strong correlation between malnutrition and risk of COPD exacerbation. The MNA®-SF is a reliable nutritional assessment tool in correlating or even predicting rates of exacerbation for COPD patients.
CLINICAL IMPLICATIONS: Assesing nutritonal status through MNA-SF, we may now be able to identify and able to predict rates of COPD exacerbations. Nutrition which is often taken for granted must always be included in COPD management. Nutritional build up will definitely help prevent exacerbations and hospital stay.
DISCLOSURE: The following authors have nothing to disclose: Peter Ian Tabar, Aileen Guzman-Banzon, Maria Encarnita Limpin
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