Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000 Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000 Aalborg, Denmark; Centre for Nutrition and Intestinal Failure, Department of Gastroenterology, Aalborg University Hospital, Sdr. Skovvej 5.1, 9000 Aalborg, Denmark.
Clin Nutr. 2023 Nov;42(11):2173-2180. doi: 10.1016/j.clnu.2023.09.012. Epub 2023 Sep 24.
Unintentional weight loss (UWL) is prevalent among patients with chronic obstructive pulmonary disease (COPD). However, little research has been done on UWL as an independent variable in terms of clinical outcome. The aim of this study was to investigate the association between BMI, UWL, and clinical outcome in terms of hospitalization, length of stay, exacerbations, mortality, and quality of life (QoL) within six months and one year in a hospital outpatient setting.
A prospective single-center cohort study enrolled 200 patients from the COPD outpatient clinic between October 2020 and May 2021 at a Danish Hospital. At baseline, data was collected using patients' electronic journals and a quantitative questionnaire was gathered with a patient-reported UWL of 5% of body weight within three months. At six months and one-year follow-ups, data was collected using the patients' medical journals and a telephonic interview with the EQ-5D-5L and SARC-F questionnaire and the number of non-hospitalization exacerbations since inclusion. Data were analyzed using logistic and Cox hazard regression analysis.
A total of 187 patients were eligible for follow-up (mean age 69.2 years, 43.9% males, median BMI 26.8 kg/m), and the prevalence of UWL was 13.4%. UWL was associated with an almost trifold risk of >five days stay (OR = 2.94, p = 0.021). Additionally, UWL was associated with a worse QoL. A higher risk of exacerbation was found in the underweight patients (OR = 4.94, p = 0.014). No significant difference in mortality was found.
UWL as a solitary factor is associated with increased hospital length of stay and a worse QoL. The results provide further evidence that implementation of regular screening for UWL in addition to BMI might be beneficial to include in international COPD guidelines for outpatient settings.
体重意外减轻（UWL）在慢性阻塞性肺疾病（COPD）患者中很常见。然而，关于 UWL 作为临床结果的独立变量的研究甚少。本研究旨在调查 BMI、UWL 与住院、住院时间、加重、死亡率和六个月和一年内生活质量（QoL）之间的关联在丹麦医院的 COPD 门诊诊所进行。
一项前瞻性单中心队列研究于 2020 年 10 月至 2021 年 5 月期间在丹麦医院的 COPD 门诊诊所招募了 200 名患者。在基线时，通过患者的电子病历收集数据，并通过患者报告的三个月内体重减轻 5%的定量问卷收集数据。在六个月和一年的随访中，通过患者的病历和电话采访使用 EQ-5D-5L 和 SARC-F 问卷以及纳入后非住院加重的次数收集数据。使用逻辑和 Cox 风险回归分析对数据进行分析。
共有 187 名患者符合随访条件（平均年龄 69.2 岁，43.9%为男性，中位数 BMI 为 26.8kg/m），UWL 的患病率为 13.4%。UWL 与住院时间超过 5 天的风险增加近三倍相关（OR=2.94，p=0.021）。此外，UWL 与 QoL 较差相关。体重不足的患者发生加重的风险更高（OR=4.94，p=0.014）。死亡率无显著差异。
作为单一因素，UWL 与住院时间延长和 QoL 下降有关。研究结果进一步表明，在国际 COPD 门诊指南中，除 BMI 外，定期筛查 UWL 可能有益。
