Malnutrition and Obesity in Patients with COPD Exacerbation, Insights from the National Inpatient Sample.

Autor:	El Labban M; Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA., El-Zibaoui R; School of Medicine, American University of Beirut, Beirut, Lebanon., Usama SM; Department of Internal Medicine, Nazareth Hospital-Trinity Health Mid Atlantic, PA, USA., Niaz F; School of Medicine, St. George's University, Grenada, West Indies., Cohen A; School of Medicine, St. George's University, Grenada, West Indies., Krastev P; School of Medicine, Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA., Khan S; Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA., Surani S; Department of Medicine & Pharmacology, Texas A&M University, College Station, TX, USA.
Jazyk:	angličtina
Zdroj:	The open respiratory medicine journal [Open Respir Med J] 2024 Aug 23; Vol. 18, pp. e18743064322829. Date of Electronic Publication: 2024 Aug 23 (Print Publication: 2024).
DOI:	10.2174/0118743064322829240801094830
Abstrakt:	Background: The obesity paradox suggests that obese patients with Chronic Obstructive Pulmonary Disease Exacerbation (COPDE) may have better outcomes. COPD patients are at a higher risk of becoming malnourished, which has been linked to poor outcomes. Objective: This paper aims to study the impact of malnutrition in patients with and without obesity hospitalized with COPDE. Methods: Our retrospective study analyzed data from the National Inpatient Sample dataset between 2017 and 2020 to observe patients who were hospitalized with COPDE. The patients were divided into two groups: with and without malnutrition. The outcomes included all-cause mortality, invasive mechanical ventilation, length of stay, and total charge. We adjusted for confounders using multivariate regression model analysis. Results: The study involved 392,920 patients with COPDE, out of which 5720 (1.45%) were diagnosed with malnutrition. Most of the patients in both groups were female, white, and under Medicare coverage. The mean age was higher in patients with malnutrition (67.6 vs . 64 years). In both groups, the rates of admissions were lowest in 2020 compared to three years prior. The rates and adjusted odds ratios of all-cause mortality were higher in patients with malnutrition (3.59% vs . 0.61%, P <0.01; adjusted odds ratio (aOR) 2.36, P<0.01, CI 1.8-3.7). We observed comparable findings when using invasive mechanical ventilation (13.2% vs . 2.82%, P<0.01, aOR 4.9, P<0.01, 3.9-6). Malnourished patients had a lengthier hospital stay and a greater total charge. Conclusion: Malnutrition was identified as an independent risk factor associated with worse outcomes in obese patients admitted with COPD exacerbation. Competing Interests: Dr. Salim Surani is the Co-Editor of The Open Respiratory Medicine Journal. (© 2024 The Author(s). Published by Bentham Open.)
Databáze:	MEDLINE
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