Malnutrition during COPD exacerbations was associated with substantially higher odds of in-hospital mortality (aOR 3.15; 95% CI 2.78-3.57; p<0.001) compared to patients without malnutrition.
Cohort (n=1,200,000)
Yes
Does malnutrition worsen inpatient outcomes in adults hospitalized for acute exacerbations of COPD?
Malnutrition during COPD exacerbations is associated with significantly higher in-hospital mortality, respiratory failure, and cardiogenic shock, emphasizing the need for early nutritional screening.
Effect estimate: aOR 3.15 (95% CI 2.78-3.57)
p-value: p=< 0.001
Abstract Background Malnutrition is a prevalent yet frequently neglected comorbidity that adversely impacts immune function, wound healing, and physiological health during acute illness 1, 2. Nutritional depletion in individuals with chronic obstructive pulmonary disease (COPD) correlates with respiratory muscle weakness, heightened vulnerability to infections, and diminished recovery following exacerbations 3, 5. We aimed to evaluate the association between malnutrition and key inpatient outcomes among adults hospitalized for acute exacerbations of COPD using a large, nationally representative cohort. Methods We used ICD-10 codes to retrospectively analyze COPD exacerbation patients from 2019-2022 in the NIS Database. Patients were divided into two groups: those with malnutrition diagnoses and those without. We compared the odds of in-hospital outcomes, adjusted for confounders, using univariate and multivariate analyses. Results Among 1. 2 million COPD exacerbation admissions, malnutrition was associated with substantially higher odds of mortality (adjusted odds ratio aOR 3. 15, 95% CI 2. 78-3. 57, p 0. 001), mechanical ventilation (aOR 2. 39, 95% CI 2. 18-2. 62, p 0. 001), acute respiratory failure (aOR 1. 75, 95% CI 1. 66-1. 84, p 0. 001), sepsis (aOR 2. 50, 95% CI 2. 08-3. 00, p 0. 001), and cardiogenic shock (aOR 3. 00, 95% CI 2. 07-4. 35, p 0. 001). Malnutrition was linked to longer hospitalizations (+1. 74 days, p 0. 001) and higher total charges (+17, 152, p 0. 001). Interestingly, AKI (aOR 0. 84, 95% CI 0. 79-0. 90, p 0. 001) and acute heart failure (aOR 0. 49, 95% CI 0. 44-0. 54, p 0. 001) occurred less frequently in malnourished patients. Conclusion Malnutrition during COPD exacerbations can be correlated with poor respiratory and infectious outcomes, higher mortality rates, and increased resource consumption. The lower incidences of AKI and heart failure may indicate differences in circulatory reserve and intravascular volume among malnourished patients 2, 3. These findings highlight the importance of early nutritional screening and intervention in COPD management for better outcomes and fewer complications 4, 5. This abstract is funded by: None
Taha et al. (Fri,) conducted a cohort in Acute exacerbations of chronic obstructive pulmonary disease (COPD) (n=1,200,000). Malnutrition vs. No malnutrition was evaluated on In-hospital mortality (aOR 3.15, 95% CI 2.78-3.57, p=< 0.001). Malnutrition during COPD exacerbations was associated with substantially higher odds of in-hospital mortality (aOR 3.15; 95% CI 2.78-3.57; p<0.001) compared to patients without malnutrition.
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