Department of Clinical Nutrition and Food Service, Saiseikai Otaru Hospital, 10-1 Thikkou, Otaru, Hokkaido 047-0008, Japan.
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Japan.
Respir Med Res. 2022 May;81:100899. doi: 10.1016/j.resmer.2022.100899. Epub 2022 May 3.
Weight loss and low lean body mass in patients with chronic obstructive pulmonary disease (COPD) are associated with increased mortality; however, the association between body mass index (BMI) and physical ability remains undetermined. We aimed to investigate the effect of BMI on activities of daily living (ADL) in hospitalized patients with COPD.
We used the Japan Medical Data Center's hospital-based database to extract data on hospitalized patients aged ≥ 20 years admitted for COPD between April 2014 and December 2018. The primary outcome was the presence or absence of deterioration in the Barthel Index score for ADLs at discharge compared with that at admission. Secondary outcomes were the length of hospital stay, readmission within 30 days, and the number of drugs administered on admission.
We identified 6529 patients with COPD from the Diagnosis Procedure Combination database, of which 3476 were analyzed (excluded: n = 5, ages < 20 years; n = 3048, missing entries). Barthel Index scores tended to decline in patients with BMI < 18.5 kg/m (odds ratio, OR: 2.030, p < 0.001) and Hugh-Jones grade 4 (OR: 1.79, p = 0.05) and grade 5 (OR: 2.15, p = 0.01), but not in the obese group (p = 0.598). The low-weight group had a significantly longer hospital stay (p < 0.001) at 14 (8-25) days with greater readmissions within 30 days (6.3%, p < 0.001).
Low BMI is associated with lower Barthel Index scores, longer hospital stays, requiring readmissions within 30 days of discharge.
慢性阻塞性肺疾病（COPD）患者体重减轻和低瘦体重与死亡率增加有关；然而，体重指数（BMI）与身体能力之间的关系仍未确定。我们旨在研究 BMI 对住院 COPD 患者日常生活活动（ADL）的影响。
我们使用日本医疗数据中心的基于医院的数据库，提取 2014 年 4 月至 2018 年 12 月期间因 COPD 住院的年龄≥20 岁患者的数据。主要结局是与入院时相比，出院时 ADL 的 Barthel 指数评分是否恶化。次要结局是住院时间、30 天内再入院和入院时给药的药物数量。
我们从诊断程序组合数据库中确定了 6529 例 COPD 患者，其中 3476 例进行了分析（排除：n=5，年龄<20 岁；n=3048，缺失条目）。BMI<18.5kg/m2 的患者 Barthel 指数评分倾向于下降（比值比，OR：2.030，p<0.001）和 Hugh-Jones 等级 4（OR：1.79，p=0.05）和等级 5（OR：2.15，p=0.01），但肥胖组无此现象（p=0.598）。低体重组的住院时间明显更长（p<0.001），为 14（8-25）天，30 天内再入院率更高（6.3%，p<0.001）。
低 BMI 与较低的 Barthel 指数评分、较长的住院时间和需要在出院后 30 天内再次入院有关。
