title: Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD).
abstract: Patients with chronic obstructive pulmonary disease (COPD) often have difficulties with keeping their weight. The aim of this investigation was to study nutritional status in hospitalised Nordic COPD patients and to investigate the association between nutritional status and long-term mortality in this patient group. In a multicentre study conducted at four university hospitals (Reykjavik, Uppsala, Tampere and Copenhagen) hospitalised patients with COPD were investigated. Patient height, weight and lung function was recorded. Health status was assessed with St. George's Hospital Respiratory Questionnaire. After 2 years, mortality data was obtained from the national registers in each country. Of the 261 patients in the study 19% where underweight (BMI <20), 41% were of normal weight (BMI 20-25), 26% were overweight (BMI 25-30) and 14% were obese. FEV(1) was lowest in the underweight and highest in the overweight group (p=0.001) whereas the prevalence of diabetes and cardio-vascular co-morbidity went the opposite direction. Of the 261 patients 49 (19%) had died within 2 years. The lowest mortality was found among the overweight patients, whereas underweight was related to increased overall mortality. The association between underweight in COPD-patients, and mortality remained significant after adjusting for possible confounders such as FEV(1) (hazard risk ratio (95% CI) 2.6 (1.3-5.2)). We conclude that COPD patients that are underweight at admission to hospital have a higher risk of dying within the next 2 years. Further studies are needed in order to show whether identifying and treating weight loss and depletion of fat-free mass (FFM) is a way forward in improving the prognosis for hospitalised COPD patients.
authors.affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden. runa.hallin@medsci.uu.se
authors.forename: Runa
authors.initials: R
authors.lastname: Hallin
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gudmundsson
authors.forename: Charlotte
authors.initials: C
authors.lastname: Suppli Ulrik
authors.forename: Markku M
authors.initials: MM
authors.lastname: Nieminen
authors.forename: Thorarinn
authors.initials: T
authors.lastname: Gislason
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.forename: Eva
authors.initials: E
authors.lastname: Brøndum
authors.forename: Tiina
authors.initials: T
authors.lastname: Aine
authors.forename: Per
authors.initials: P
authors.lastname: Bakke
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D004812:Epidemiologic Methods; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000503:physiopathology*; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D013851:Thinness