Mini nutritional assessment, body composition, and hospitalisations in patients with chronic obstructive pulmonary disease.

BACKGROUND

Limited information is available about Mini Nutritional Assessment (MNA) questionnaire in patients with chronic obstructive pulmonary disease (COPD). We have conceived this analysis to study the associations between MNA questionnaire, body composition, and rehospitalisations in patients with COPD.

METHODS

This prospective study recruited control subjects and COPD patients for pulmonary function testing, nutritional assessment using MNA questionnaire, body composition measurement, and dyspnoea evaluation. We recorded hospitalisations during 6 months after discharge.

RESULTS

Our sample included 22 healthy controls (71 ± 5 years, 59% men) and 108 COPD patients (71 ± 10 years, 75% men, 85% severe or very severe COPD). MNA score was significantly higher in control subjects than in COPD patients (27.0 ± 1.7 vs 21.2 ± 4.9, p < 0.001). MNA score decreased over GOLD stage (p = 0.02) and indicated malnutrition in 14% of patients, and further 55% were at risk of malnutrition. Body mass index but not body composition parameters was higher in control subjects when compared to COPD patients (29.1 ± 3.8 vs 27.0 ± 6.3, p = 0.041). A positive correlation between MNA score, body fat content (p = 0.001), and lean body mass (p < 0.001) was observed. During follow-up, 45 (41%) patients were rehospitalised. Malnourished patients had higher risk of rehospitalisation in univariate analysis (HR 2.62, 95%Cl 1.13-6.07), which was maintained in an adjusted model (HR 2.93, 95%CI 1.05-7.32).

CONCLUSIONS

Malnutrition and risk of malnutrition was frequent, associated with lower body fat mass and lean body mass, and independently predicted hospitalisations at six months.