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.
Br J Nutr. 2018 Mar;119(5):543-551. doi: 10.1017/S0007114517003919.
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.
低能量和蛋白质摄入与慢性阻塞性肺疾病（COPD）门诊患者营养不良风险增加有关。我们旨在根据营养风险状况和需求评估住院 COPD 患者的能量和蛋白质摄入量，以及来自餐食、零食、饮料和口服营养补充剂（ONS）的相对贡献，并检查能量或蛋白质摄入量是否可以预测结局。
研究对象为 99 例在 1 年内（2015 年 3 月至 2016 年 3 月）入住 Landspitali 大学医院的 COPD 患者。采用验证过的筛查工具对患者进行营养风险筛查，使用验证过的餐盘图表估计患者入院后 3 天和 1-5 天的能量和蛋白质摄入量。达到能量和蛋白质需求≥75%的患者比例平均分别为 59%和 37%。营养不良患者在进餐时摄入较少，ONS 摄入较多，因此两组患者的总能量和蛋白质摄入量无差异。
尽管能量摄入与需求的百分比与 12 个月随访时的死亡率呈边缘显著相关（OR 0.12；95%CI 0.01，1.15；P=0.066），但未发现能量或蛋白质摄入与结局之间存在明确关联。
在研究人群中，住院期间的能量和蛋白质摄入未能满足需求。需要进一步研究如何增加住院和出院后患者的能量和蛋白质摄入，并评估住院 COPD 患者摄入与需求相关的更高摄入量是否会带来更好的结局。
