title: Malnutrition screening in patients admitted to hospital with an exacerbation of chronic obstructive pulmonary disease and its association with patient outcomes.
abstract: OBJECTIVE
  There is a paucity of information on the prevalence and clinical implications of malnutrition in patients hospitalised for management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This study aimed to fill this gap in knowledge.
  
  
  METHODS
  We performed a retrospective observational cohort study of 100 hospitalised AECOPD patients. The Malnutrition Screening Tool (MST) was used to identify patients at risk of malnutrition (MST ≥2). Patient characteristics, length of stay, readmission rate, 12-month survival and overall survival were collected using a proforma.
  
  
  RESULTS
  MST scores were available in 90 patients, of whom 22% of patients had a MST score of ≥2. There were no significant differences in COPD severity, treatment received and biochemical parameters between the groups of patients 'at risk of malnutrition' and those 'not at risk of malnutrition'. Length of stay in hospital was longer in patients 'at risk of malnutrition' (median (IQR): 3.5 (2-7.5) vs. 3.0 (1-5), p = 0.048). Overall survival was significantly reduced in patients with 'at risk of malnutrition' compared to those patients 'not at risk of malnutrition' (337 ± 245 vs. 670 ± 292, p < 0.001).
  
  
  CONCLUSIONS
  Using the MST we found that one-fifths of our hospitalised AECOPD patients are at 'at risk of malnutrition'. Moreover, this cohort of patients had worse outcomes both during and extending beyond hospitalisation compared to patients 'not at risk of malnutrition'. Our study illustrates the need for routine malnutrition screening for hospitalised AECOPD patients because it has implications for potentially reducing morbidity and mortality in COPD.
authors: a School of Medicine, Parklands Drive , Griffith University , Southport , Australia.
authors: Stephanie
authors: S
authors: Law
authors: a School of Medicine, Parklands Drive , Griffith University , Southport , Australia.
authors: Praneel
authors: P
authors: Kumar
authors: b Nutrition and Food Services , Gold Coast University Hospital , Southport , Australia.
authors: Sharon
authors: S
authors: Woods
authors: a School of Medicine, Parklands Drive , Griffith University , Southport , Australia.|c Department of Respiratory Medicine , Gold Coast University Hospital , Southport , Australia.
authors: Krishna B
authors: KB
authors: Sriram
keywords: Chronic obstructive pulmonary disease; exacerbation; malnutrition; screening; survival