Prospective cohort study finds sarcopenia predicts acute exacerbations and increases mortality risk in elderly COPD patients.
Background and Aim: The aim of this study was to examine the effects of sarcopenia on clinical features and short-term outcomes in elderly chronic obstructive pulmonary disease (COPD) patients.Materials and Methods: Multicenter cohort study was performed. Elderly COPD patients (age>65) were divided into sarcopenia and non-sarcopenia groups according to the diagnosis of sarcopenia at the first admission. Baseline data, geriatric syndrome, lab indicators and body composition analysis were analyzed. Primary endpoint was occurrence of acute exacerbations (AE) of COPD in the two groups, with an evaluation of all cause-one year-mortality. Cox regression was performed to explain the effect of sarcopenia on COPD patients’ prognosis.Results: 326 subjects (206 men and 120 women) with an average age of 77.4±7.9 years were enrolled, of which 176 patients (53.9%) with sarcopenia. Compared to the non-sarcopenia group, the sarcopenia group showed worse lung function, poor quality of life and higher incidence ratios of frailty. After adjusting by Barthel Index, polypharmacy, comorbidity and age, the incidence of sarcopenia was a significant independent predictor of AE in elderly patients with COPD (HR=2.8, 95% CI: 1.2-6.32, p=0.04). Higher mortality was shown in over 80ys subjects of sarcopenia group (HR 2.1, 95% CI: 1.08-8.67, p=0.048).Conclusions: Sarcopenia could increase the risk of acute exacerbations of COPD in the elderly, with a poor prognosis in over 80ys subgroup. Screening for sarcopenia at the admission in hospital could influence management and prognosis of these patients.
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