[Prevalence of malnutrition among candidates for lung transplantation].
OBJECTIVE
To analyse the prevalence of malnutrition in candidates for lung transplantation and to establish if there are any differences in the prevalence of malnutrition among the different groups of patients regarding their illness.


METHODS
We reviewed the nutritional evaluation of 163 consecutive transplant candidates referred to our hospital (1996-2001). The nutritional assessment included: clinical history, anthropometric measurements, bioelectrical impedance analysis, and biochemical measurements. The nutritional status diagnosis was determined following RWS Chang protocol.


RESULTS
163 patients (108 male/55 female; 42.9 +/- 14.7 yr.) agrupped into four main lung diseases groups: obstructive (chronic obstructive pulmonary disease): 60 (36.8%); interstitial (idiopathic pulmonary fibrosis): 45 (27.6%); septic (cystic fibrosis and bronchiectasis): 47 (28.8%); and vascular (primary pulmonary hypertension and miscellaneous etiology): 11 (6.7%). The prevalence of malnutrition is 60.9% (IC 95%; 53.4-68.4) and the most prevalent type is moderate caloric malnutrition (23.3%). Percentage of triceps skinfold thickness was lower in the septic group (65.1 +/- 43.0) than in the obstructive (94.8 +/- 53.9; p < 0.05) or in the interstitial one (130.3 +/- 61.5; p < 0.0001). Interstitial group had also the higher weight, BMI and percentage of ideal weight. Percentage of arm muscle circumference was only different between interstitial and septic groups (105.5 +/- 18.3 vs 95.9 +/- 11.1; p < 0.01). Resting energy expenditure was lower in septic patients. This group had lower levels of prealbumin than obstructive (17.6 +/- 4.7 vs 24.4 +/- 4.8 mg/dl; p < 0.0001) or interstitial groups (17.6 +/- 4.7 vs 27.3 +/- 7.7 mg/dl; p < 0.0001).


CONCLUSIONS
Malnutrition in patients awaiting lung transplantation is highly prevalent, specially in septic and vascular lung diseases. Anthropometric measurements are a good and easy option to explore this problem. Nutritional rehabilitation of these patients could improve their postoperative course.
Calañas-Continente
A J
AJ
S. de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal, s/n, 14004 Córdoba. alcont@nhcges.com
Cerveró Pluvins
C
C
Muñoz Gomariz
E
E
Lama Martínez
R
R
Font Ugalde
P
P
Molina Puerta
M J
MJ
Santos Luna
F
F
D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D003953:Diagnosis-Related Groups; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D009765:Obesity / Q000150:complications; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D011658:Pulmonary Fibrosis / Q000150:complications; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications; D013030:Spain / Q000453:epidemiology; D014652:Vascular Diseases / Q000150:complications