Highlights
- •A total of 438 COPD patients with respiratory failure in 3 years of interval.
- •The best nutritional assessment method varies in prediction of different prognosis.
- •ALB level is superior to predict the short term prognosis.
- •NRS 2002 is better for the prediction of long-term clinical outcome.
Abstract
Objectives
Due to their increased energy expenditure, chronic obstructive pulmonary disease (COPD)
patients with respiratory failure are susceptible to malnutrition. This study aimed
to compare the predictive values of the following three widely used nutritional assessment
methods for the clinical prognosis of COPD patients with respiratory failure: body
mass index (BMI), Nutritional Risk Screening 2002 (NRS 2002), and serum albumin (ALB)
level.
Methods
COPD patients with respiratory failure treated in our center from June 2013 to June
2016 were retrospectively included. Patient BMI, NRS 2002 and ALB values were measured
to assess their nutritional status. A multivariable analysis was conducted, and receiver
operating characteristic (ROC) curves were generated to explore the predictive factors
for clinical prognoses.
Results
A total of 438 qualified patients were enrolled in our study. Multivariable analysis
revealed that the BMI and ALB values independently predicted in-hospital mortality,
the BMI and NRS 2002 predicted 1-year mortality, and all three methods (BMI, NRS 2002,
and ALB) predicted 30-day readmission after discharge (P < 0.05). Regarding the results of the AUROC analysis, the optimal cutoff values that
maximized the ability to predict the prognosis were an ALB level of 30.5 g/L for in-hospital
mortality, an NRS 2002 score of 3 points for 1-year mortality, and an ALB level of
30.1 g/L for readmission within 30 days following discharge.
Conclusions
For COPD patients with respiratory failure, ALB level was superior for predicting
in-hospital mortality and 30-day readmission after discharge, and NRS 2002 was superior
for long-term prognosis of 1-year mortality.
Keywords
Abbreviation list:
ALB (Serum albumin), AUROC (Area under the ROC curve), BMI (Body mass index), CI (Confidence intervals), COPD (Chronic obstructive pulmonary disease), HIS (Hospital information system), IRB (Institutional review board), LR (Likelihood ratio), NRS 2002 (Nutritional Risk Screening 2002), OR (Odds ratio), ROC (Receiver operating characteristic), SD (Standard deviation), WCH (West China Hospital)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 12, 2018
Accepted:
June 6,
2018
Received in revised form:
June 2,
2018
Received:
February 2,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
