Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
BMJ Open Respir Res. 2023 Jul;10(1). doi: 10.1136/bmjresp-2022-001518.
Malnutrition negatively affects patients with chronic obstructive pulmonary disease (COPD). This study aimed to explore the potential association between malnutrition, as defined by the Geriatric Nutritional Risk Index (GNRI), and all-cause mortality in patients with COPD using the National Health and Nutrition Examination Survey (NHANES).
The data of 579 adults with COPD during NHANES 2013-2018 were analysed. Each patient was assigned to one of the two groups according to GNRI values: normal nutritional status (GNRI>98) and malnutrition status (GNRI≤98). Survival curves and Cox regressions were applied to evaluate the association between nutritional status and mortality.
Overall, the mean age was 63.4±0.5 years, and 53.9% of the patients were women. The prevalence of malnutrition was 6.6%, and the Kaplan-Meier curves for all-cause mortality according to nutritional status showed that malnutrition was associated with a higher incidence of all-cause mortality. The Cox regression analysis found that in the unadjusted model, the HR was 2.30 (95% CI 1.24 to 4.27, p=0.01). In the fully adjusted model, the adjusted HR was 2.47 (95% CI 1.36 to 4.5, p=0.003). Furthermore, subgroup analysis revealed that the risk of death due to malnutrition increased more than threefold in the low education and cancer subgroups.
A low GNRI was an independent risk factor for all-cause mortality in patients with COPD.
营养不良会对慢性阻塞性肺疾病（COPD）患者产生负面影响。本研究旨在通过国家健康和营养检查调查（NHANES），探讨老年营养风险指数（GNRI）定义的营养不良与 COPD 患者全因死亡率之间的潜在关联。
分析了 NHANES 2013-2018 年期间 579 名 COPD 成年患者的数据。根据 GNRI 值将每位患者分为两组：营养状况正常（GNRI＞98）和营养不良状态（GNRI≤98）。应用生存曲线和 Cox 回归评估营养状况与死亡率之间的关系。
总体而言，患者的平均年龄为 63.4±0.5 岁，其中 53.9%为女性。营养不良的患病率为 6.6%，根据营养状况的全因死亡率 Kaplan-Meier 曲线显示，营养不良与全因死亡率的发生率较高相关。Cox 回归分析发现，在未调整模型中，HR 为 2.30（95%CI 1.24 至 4.27，p=0.01）。在完全调整模型中，调整后的 HR 为 2.47（95%CI 1.36 至 4.5，p=0.003）。此外，亚组分析表明，在低教育程度和癌症亚组中，由于营养不良导致死亡的风险增加了三倍以上。
GNRI 较低是 COPD 患者全因死亡率的独立危险因素。
