Malnutrition : An independent risk factor of an early readmission for acute exacerbation in COPD

Abstract

<b>Introduction:</b> The readmission rate for chronic obstructive pulmonary disease (COPD) exacerbations has become a common and challenging clinical problem. Few studies have investigated malnutrition as a factor in readmission for acute exacerbation of COPD (AECOPD). <b>Objective:</b> To investigate malnutrition as a risk factor for early readmission for AECOPD. <b>Methods:</b> We conducted a cross-sectional study in a cohort of consenting patients followed up for confirmed COPD with a history of AECOPD at the pulmonology department Pavilion IV of Abderrahman Mami Pulmonology Hospital, between January and December 2022. The time to readmission considered was 90 days. Disease severity was assessed using the Global Initiative on Obstructive Lung Disease (GOLD) 2022 recommendations. <b>Results:</b> We included 108 male patients with a mean age of 66.01± 9.36 years. Readmission for AECOPD within 90 days was noted in 59 (54.6%) patients. Readmission for AECOPD was significantly associated with a Body Mass Index (BMI) less than 18 kg/m2 (57.7%, p=0.002) and weight loss &gt;5% (73%, p=0.001). Biologically, hypoprotidemia, hypoalbuminemia, anemia and lymphopenia were correlated with early readmission for AEBPCO (p=0.002, p=0.02 and p=0.01, respectively). These parameters were positively associated with the use of non-invasive ventilation during exacerbations (p=0.03, p=0.04 and p&lt;10-3 respectively) and with subsequent progression to chronic respiratory failure (p=0.04, p=0.04 and p=0.03 respectively). In multivariate analysis, these parameters were independent risk factors for a hospital stay for more than six days. <b>Conclusion:</b> Malnutrition is a risk factor for early readmission for AECOPD and chronic repiratory failure.