Evaluation Of Malnutrition In Chronic Obstructive Pulmonary Disease And Analysis Of Related Risk Factors

Purpose:The mini nutritional assessment short-form(MNA-SF)was used to evaluate the nutritional status of hospitalized COPD patients.To screen the possible risk factors of malnutrition in COPD patients.Methods:Ninety-seven patients with COPD who were hospitalized in the respiratory department of Wuhu Second People’s Hospital from September 1,2021 to August 31,2022 were selected.1.The MNA-SF scale was used to evaluate the nutritional status of patients,and the patients were divided into two groups according to the evaluation results:normal nutrition group and malnutrition group.MNA-SF value≥11 points,which is normal nutrition group.MNA-SF value<11 points,which is malnutrition group.2.Compare the general conditions(gender,age,smoking history,drinking history,times of acute exacerbations in one year,ventilator use,etc.),body mass index(BMI),chronic obstructive pulmonary disease assessment test(CAT score),related clinical indicators(C-reactive protein,blood routine,biochemical indicators,procalcitonin,etc.),lung function,arterial blood gas results,hospitalization days,and discuss the nutritional status between the two groups.3.Statistical software SPSS 25.0 was used for data analysis.The measurement data are expressed by the mean±standard deviation,and the measurement data satisfying the normal distribution are compared between the two groups by T test.Mann-WhitneyU rank sum method was used to compare the measurement data that did not meet the normal distribution between the two groups.The data were expressed in percentage(%),and chi-square test was used in comparison between groups.Perrson test was used for correlation analysis.The risk factors of malnutrition were analyzed by multivariate Logistic regression analysis,and the difference was statistically significant(P<0.05).Results:1.After the nutritional status of 97 patients was assessed by MNA-SF scale,it was found that there were 36 patients with normal nutrition,61 patients with malnutrition,and 62.9%of COPD patients with malnutrition.2.BMI,albumin,oxygen partial pressure,FEV1%,FEV1/FVC%,PEF%,MVV%in malnutrition group were lower than those in normal nutrition group,and the difference was statistically significant(P<0.05).Age,C-reactive protein,partial pressure of carbon dioxide,CAT score and hospital stay were all higher than those in the normal nutrition group,with statistical difference(P<0.05).There was no significant difference in serum cholesterol,hemoglobin and lymphocyte count between the two groups(p>0.05).There was no statistical difference in sex between the two groups.3.MNA-SF score was significantly correlated with CAT score,C-reactive protein,lung function and blood gas analysis.Among them,MNA-SF score was positively correlated with PEF,MVV,FEV1%,FEV1/FVC and oxygen partial pressure(R values were 0.524,0.318,0.390,0.219 and 0.526 respectively),while MNA-SF score was negatively correlated with CAT score,C-reactive protein and carbon dioxide partial pressure(R values were-0.545、-0.227and-0.702 respectively).4.Single factor analysis of COPD malnutrition,using binary logistic regression model,the results showed that ventilator use,times of acute exacerbations in a year,time of illness(year),and types of combined diseases were independent risk factors of COPD malnutrition.Conclusion:1.Inpatients with acute exacerbation of COPD have different degrees of malnutrition,and the incidence of malnutrition in this study is 62.9%.2.Age,length of stay,pulmonary function,arterial blood gas analysis and CAT score are related to COPD complicated with malnutrition.The older the patient is,the worse the nutritional status(MNA-SF score is high).The longer the patient is in hospital,the worse the results of pulmonary function and blood gas analysis and the higher the CAT score.3.Whether to use ventilator,the times of acute exacerbations in a year,the time of illness,and the types of diseases are the risk factors of COPD complicated with malnutrition.