Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)

Arora Ros Ingadottir; Anne Marie Beck; Christine Baldwin; C. Elizabeth Weekes; Olof Gudny Geirsdottir; Alfons Ramel; Thorarinn Gislason; Ingibjorg Gunnarsdottir

doi:10.1016/j.clnu.2017.05.031

Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)

Arora Ros Ingadottir, Anne Marie Beck, Christine Baldwin, C. Elizabeth Weekes, Olof Gudny Geirsdottir, Alfons Ramel, Thorarinn Gislason, Ingibjorg Gunnarsdottir

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Abstract

IntroductionLow fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality. Methods Subjects were COPD patients (n=121) admitted to Landspitali University Hospital from March 2015-March 2016. Patients were screened for nutritional risk using Icelandic screening tool (ISS) and NRS-2002. Body composition was measured by bioelectrical impedance analysis (BIA). Lung function was measured by spirometry. ResultsThe prevalence of malnutrition according to the ESPEN criteria was 21%. The association between nutritional assessment, applying different components of the ESPEN criteria, and COPD severity was highly significant, with the highest risk being associated with low FFMI OR (95% CI) 4.77 (2.03, 11.20; p<0.001). There was a trend towards higher risk of hospitalization for >7 days in subjects with low FFMI (OR 2.46 95% CI 0.92, 6.59; p=0.074) and increased risk of 6 and 9 months’ mortality (OR 2.72 95% CI 0.88, 8.39, P=0.082 and OR 2.72 95% CI 0.94, 7.87, P=0.065, respectively) in subjects diagnosed as malnourished by the ESPEN criteria. ConclusionThis study describes the prevalence of malnutrition in hospitalized COPD patients using the ESPEN criteria from 2015. Our findings suggest that FFMI could be used independently of weight loss for the diagnosis of malnutrition in COPD patients, although there remain some problems associated with its measurement in the clinical setting.

Original language	English
Journal	CLINICAL NUTRITION
Early online date	8 Jun 2017
DOIs	https://doi.org/10.1016/j.clnu.2017.05.031
Publication status	E-pub ahead of print - 8 Jun 2017

Keywords

Malnutrition
COPD
ESPEN malnutrition definition
Nutritional screening

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.clnu.2017.05.031

Two components of the_INGADOTTIR_Published online 8 June 2017_GREEN AAM (CC BY-NC-ND)Accepted author manuscript, 778 KBLicence: CC BY-NC-ND

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Ingadottir, A. R., Beck, A. M., Baldwin, C., Weekes, C. E., Geirsdottir, O. G., Ramel, A., Gislason, T., & Gunnarsdottir, I. (2017). Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD). CLINICAL NUTRITION. Advance online publication. https://doi.org/10.1016/j.clnu.2017.05.031

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title = "Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)",

abstract = "IntroductionLow fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality. Methods Subjects were COPD patients (n=121) admitted to Landspitali University Hospital from March 2015-March 2016. Patients were screened for nutritional risk using Icelandic screening tool (ISS) and NRS-2002. Body composition was measured by bioelectrical impedance analysis (BIA). Lung function was measured by spirometry. ResultsThe prevalence of malnutrition according to the ESPEN criteria was 21%. The association between nutritional assessment, applying different components of the ESPEN criteria, and COPD severity was highly significant, with the highest risk being associated with low FFMI OR (95% CI) 4.77 (2.03, 11.20; p<0.001). There was a trend towards higher risk of hospitalization for >7 days in subjects with low FFMI (OR 2.46 95% CI 0.92, 6.59; p=0.074) and increased risk of 6 and 9 months{\textquoteright} mortality (OR 2.72 95% CI 0.88, 8.39, P=0.082 and OR 2.72 95% CI 0.94, 7.87, P=0.065, respectively) in subjects diagnosed as malnourished by the ESPEN criteria. ConclusionThis study describes the prevalence of malnutrition in hospitalized COPD patients using the ESPEN criteria from 2015. Our findings suggest that FFMI could be used independently of weight loss for the diagnosis of malnutrition in COPD patients, although there remain some problems associated with its measurement in the clinical setting.",

keywords = "Malnutrition, COPD, ESPEN malnutrition definition, Nutritional screening",

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

year = "2017",

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doi = "10.1016/j.clnu.2017.05.031",

language = "English",

journal = "CLINICAL NUTRITION",

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T1 - Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)

AU - Ingadottir, Arora Ros

AU - Beck, Anne Marie

AU - Baldwin, Christine

AU - Weekes, C. Elizabeth

AU - Geirsdottir, Olof Gudny

AU - Ramel, Alfons

AU - Gislason, Thorarinn

AU - Gunnarsdottir, Ingibjorg

PY - 2017/6/8

Y1 - 2017/6/8

N2 - IntroductionLow fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality. Methods Subjects were COPD patients (n=121) admitted to Landspitali University Hospital from March 2015-March 2016. Patients were screened for nutritional risk using Icelandic screening tool (ISS) and NRS-2002. Body composition was measured by bioelectrical impedance analysis (BIA). Lung function was measured by spirometry. ResultsThe prevalence of malnutrition according to the ESPEN criteria was 21%. The association between nutritional assessment, applying different components of the ESPEN criteria, and COPD severity was highly significant, with the highest risk being associated with low FFMI OR (95% CI) 4.77 (2.03, 11.20; p<0.001). There was a trend towards higher risk of hospitalization for >7 days in subjects with low FFMI (OR 2.46 95% CI 0.92, 6.59; p=0.074) and increased risk of 6 and 9 months’ mortality (OR 2.72 95% CI 0.88, 8.39, P=0.082 and OR 2.72 95% CI 0.94, 7.87, P=0.065, respectively) in subjects diagnosed as malnourished by the ESPEN criteria. ConclusionThis study describes the prevalence of malnutrition in hospitalized COPD patients using the ESPEN criteria from 2015. Our findings suggest that FFMI could be used independently of weight loss for the diagnosis of malnutrition in COPD patients, although there remain some problems associated with its measurement in the clinical setting.

AB - IntroductionLow fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality. Methods Subjects were COPD patients (n=121) admitted to Landspitali University Hospital from March 2015-March 2016. Patients were screened for nutritional risk using Icelandic screening tool (ISS) and NRS-2002. Body composition was measured by bioelectrical impedance analysis (BIA). Lung function was measured by spirometry. ResultsThe prevalence of malnutrition according to the ESPEN criteria was 21%. The association between nutritional assessment, applying different components of the ESPEN criteria, and COPD severity was highly significant, with the highest risk being associated with low FFMI OR (95% CI) 4.77 (2.03, 11.20; p<0.001). There was a trend towards higher risk of hospitalization for >7 days in subjects with low FFMI (OR 2.46 95% CI 0.92, 6.59; p=0.074) and increased risk of 6 and 9 months’ mortality (OR 2.72 95% CI 0.88, 8.39, P=0.082 and OR 2.72 95% CI 0.94, 7.87, P=0.065, respectively) in subjects diagnosed as malnourished by the ESPEN criteria. ConclusionThis study describes the prevalence of malnutrition in hospitalized COPD patients using the ESPEN criteria from 2015. Our findings suggest that FFMI could be used independently of weight loss for the diagnosis of malnutrition in COPD patients, although there remain some problems associated with its measurement in the clinical setting.

KW - Malnutrition

KW - COPD

KW - ESPEN malnutrition definition

KW - Nutritional screening

U2 - 10.1016/j.clnu.2017.05.031

DO - 10.1016/j.clnu.2017.05.031

M3 - Article

SN - 0261-5614

JO - CLINICAL NUTRITION

JF - CLINICAL NUTRITION

ER -

Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)

Abstract

Keywords

UN SDGs

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