Nutrition Risk Index: A predictive metric of severity and subsequent lung impairment in COPD

Abstract

<b>Introduction:</b> The nutritional risk index (NRI) is a nutritional evaluation score that is considered to be a powerful tool to assess patient outcomes in numerous diseases. <b>Objective:</b> To assess the association between Nutrition Risk Index and COPD severity. <b>Methods:</b> A cross sectional-study was conducted at the pulmonology Department Pavilion IV in the pulmonology hospital Abderrahman Mami, between January and December 2022. We screened consenting patients followed for stable COPD with a history of acute exacerbation of COPD (AECOPD). The Risk Nutritional Index (NRI) was applied to investigate malnourishment. Disease severity was assessed using the Global Initiative on Obstructive Lung Disease (GOLD) 2022 recommendations. <b>Results:</b> The sample included 108 patients, all male. The mean age was 66.01± 9.36 years. The mean body mass index (BMI) was 21,09 ± 4,94 Kg/m2. Malnutrition according to NRI was found in 69 (65%) of patients; 12,5% had mild malnourishment, 15% had moderate malnourishment and 37,5% had severe malnourishment. Low NRI indicating severe malnourishment was significantly associated with stage C and D of the ABCD assessment tool (p=0,001). The NRI score had a positive correlation with CAT scores (r=0.547, P&lt;10^-3), the absence of family support (r=0.42, P&lt;10^-3) and with the length of stay at the hospital during AECOPD (r=0.231, p=0.021). There was a significant negative correlation between NRI scores and forced expiratory volume in 1s (r=-0.223, p=0,049). Remarkably, low NRI scores were strongly associated with subsequent chronic respiratory failure in 28 (26%) of cases (p=0,001). <b>Conclusion:</b> This study highlights that NRI could be a powerful tool to early prediction of COPD severity.