The relationship between the nutritional status, body-mass index of patients with chronic obstructive pulmonary disease and respiratory failure and their 1-year survival

Abstract

Aim: We aimed to determine whether chronic obstructive pulmonary disease (COPD) and respiratory failure patients' characteristics can be defined as additional criteria to Body Mass Index (BMI), Nutritional Risk Screening (NRS-2002), and Albumin affecting the 1-year mortality. Material and Method: One hundred eighty-sixes patients who have been hospitalized in the Pulmonary Intensive Care Unit between 01.01.2019 and 31.12.2019 were included in our study. Results: The study comprised 186 patients and 63.5% of them were male (n=118) and 36.5% were female (n=68). The 1-year mortality of the patients after discharge was evaluated in two groups: those who died within 1 year (n=87, 46.7%) and the survivors' group (n=99, 53.3%). We found a significant difference between the survivors and the deceased patients in terms of weight, nutrition score, number of stays in the hospital, number of readmissions to the emergency service after discharge, and NRS-2002 score (p<0.05). Cox regression analysis revealed that the number of stays in the hospital, NRS-2002 score, and C-Reactive Protein (CRP) variables significantly affect the survival of the patients (p <0.05). All patients were divided into two groups (NRS-2002<4 vs. NRS-2002≥4) according to the median value of NRS-2002. Thus, the survival analysis of two different groups was compared as a risk group and a high-risk group in terms of nutritional status. There was a statistically significant difference between the NRS-2002 groups in terms of survival times. The survival time of the cases in the NRS-2002 score ≥4 group was significantly lower than the cases in the NRS-2002 score <4 group. Conclusion: We demonstrated that NRS-2002, CRP, and prolonged stay in the hospital have a relationship with the increased mortality risk. Combining NRS-2002 score ≥4 with elevated CRP levels at admission, may produce more accurate results in evaluating a patient's nutritional status in clinical practice and help make predictions about the patient's prognosis. More studies may evaluate the nutritional status of COPD patients, not only in hospitals but also in outpatient clinics.