Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease

Arora  Ros; Anne M Beck; Christine Baldwin; C Elizabeth Weekes; Olof G Geirsdottir; Alfons Ramel; Thorarinn Gislason; Ingibjorg Gunnarsdottir

doi:10.1017/S0007114517003919

Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease

Arora Ros, Anne M Beck, Christine Baldwin, C Elizabeth Weekes, Olof G Geirsdottir, Alfons Ramel, Thorarinn Gislason, Ingibjorg Gunnarsdottir

1Unit for Nutrition Research,Landspitali University Hospital& Faculty of Food Science and Nutrition,University of Iceland,101 Reykjavik,Iceland.
3Department of Nutrition and Health, Faculty of Health and Technology,Metropolitan University College,Copenhagen N,2200 Copenhagen N,Denmark.
5Division of Diabetes and Nutritional Sciences,King's College London,London SE1 9NH,UK.
University of Iceland

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Abstract

Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015-March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1-5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.

Original language	English
Pages (from-to)	543-551
Number of pages	9
Journal	British Journal of Nutrition
Volume	119
Issue number	5
Early online date	6 Mar 2018
DOIs	https://doi.org/10.1017/S0007114517003919
Publication status	Published - 14 Mar 2018

Keywords

Malnutrition
Chronic obstructive pulmonary disease
Mortality
Readmission
Length of stay

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title = "Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease",

abstract = "Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015-March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1-5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.",

keywords = "Malnutrition, Chronic obstructive pulmonary disease, Mortality, Readmission, Length of stay",

author = "Arora Ros and Beck, {Anne M} and Christine Baldwin and Weekes, {C Elizabeth} and Geirsdottir, {Olof G} and Alfons Ramel and Thorarinn Gislason and Ingibjorg Gunnarsdottir",

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T1 - Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease

AU - Ros, Arora

AU - Beck, Anne M

AU - Baldwin, Christine

AU - Weekes, C Elizabeth

AU - Geirsdottir, Olof G

AU - Ramel, Alfons

AU - Gislason, Thorarinn

AU - Gunnarsdottir, Ingibjorg

PY - 2018/3/14

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N2 - Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015-March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1-5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.

AB - Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015-March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1-5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.

KW - Malnutrition

KW - Chronic obstructive pulmonary disease

KW - Mortality

KW - Readmission

KW - Length of stay

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DO - 10.1017/S0007114517003919

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SN - 0007-1145

VL - 119

SP - 543

EP - 551

JO - British Journal of Nutrition

JF - British Journal of Nutrition

IS - 5

ER -

Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease

Abstract

Keywords

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