Accuracy Of Three Nutritional Evaluation Methods And Their Correlation With BODE Index In Patients With COPD

【Objective】The purpose of the study mainly contributes to understanding the correlation and consistency of BCA,and BODE index indicators with total scores by applying the three methods of comprehensive nutrition evaluation which include MNA-SF,SGA,and NEFFFE-CHI.Meanwhile,by following the three evaluation methods to explore the most accurate nutrition assessment for patient with chronic obstructive pulmonary disease(COPD).【Method】The method of this research selected 271 inpatients with COPD from the First Affiliated Hospitals of Hainan Medical University as sample.On the day patient admitted to the hospital,background information such as gender,age,education level,monthly family income,and medical histories has been collected for further studies.On the second day of admission,patient’s weight and height measured in the fasting state,and patient’s BMI,also completed the measurement the upper arm circumference and triceps skinfold thickness;at the same time,by applying the venipuncture for blood collection to monitor patient’s serum albumin(ALB)、serum pre-albumin(PA),and total lymphocyte count(TLC).Followed by BCA method of nutritional evaluation,from the first day patient arrived on ward in the morning0700 am ended in next morning,future 24-hour urine has been collected to monitor and calculate patient’s creatinine and weight index(CWI).Patient’s nutritional status has evaluated by using the MNA-SF,SGA,and NUFFE-CHI scales within 48 hours during admission.In addition to monitor and inspect patient’s FEV1%pred,grading for dyspnea level,and 6-minute walk gait.Through the flexible application of SPSS22.0 statistical software,by enter all the objective data for statistical analysis,t-test,Wilcoxon rank sum test,analysis of variance,and correlation analysis to complete patient’s BODE index evaluation.【Result】1.According to the BCA evaluation,92/271(33.95%)stay with normal nutrition,but 179/271 cases indicate to malnutrition which include 87/271(32.10%)mild malnutrition,53/271(19.56 %)moderate malnutrition,and 39/271(14.39%)severely malnutrition.Moreover,62/119(52.10%)malnourished elderly whose age between 60 to 70,64/85(75.29%)malnutrition patient at age 71 to 80-year-old,also patients at age 81-year-old or above with malnutrition take an important portion,the results came up to 53/67(79.10%).2.The main or median value of each single nutrition index of BCA was significantly higher in nutrition patients than malnutrition patients through the BCA,MNA-SF,SGA,and NUFFE-CHI evaluations.The difference between the two groups have statistically significance(P <0.001).3.The evaluation results of MNA-SF,SGA,and NUFFE-CHI were all related to the single nutritional index of BCA(P <0.001).Likewise,there was a positive correlation between MNA-SF and each BCA indicator(r=0.529~0.794,P <0.001);SGA and BCA were negatively correlated(r=-0.495~-0.662,P <0.001);NUFFE-CHI was negatively correlated with each BCA indicator(r=-0.456~-0.688,P <0.001).4.There was consistency between MNA-SF,SGA and NUFFE-CHI and BCA(P <0.001).The kappa value of MNA-SF and BCA was 0.797,the kappa value of SGA and BCA was 0.290,NUFFE-CHI and BCA.Kappa is 0.780.5.There was a correlation between MNA-SF,SGA,NUFFE-CHI and BODE indexes and total scores(P <0.001).More specifically,MNA-SF was positively correlated with BMI,FEV1%pred,and 6min walking distance in the BODE index(r=0.778~0.794,P <0.001),and negatively correlated with dyspnea grade and BODE total score(r=-0.751~-0.833,P <0.001);SGA was negatively correlated with BMI,FEV1%pred,and 6 min walking distance in the BODE index(r=-0.557~-0.597,P <0.001),and positively correlated with dyspnea grade and BODE total score(r=0.525~0.597,P <0.001).Along this line of considerations,NUFFE-CHI positively correlated with grade of dyspnea,BODE score(r=0.636~0.754,P <0.001),and negative correlation between BMI,FEV1%pred,and 6min-walking distance.(r=-0.688~-0.730,P <0.001).【Conclusion】To sum up,MNA-SF is a comprehensive nutrition assessment method with highly accuracy and reflecting the characteristics of COPD.It can be a proper tool for nursing professionals to assess clients’ nutritional states which is more accurate and suitable for clients with COPD.The study proves SGA scale is easily lead to misdiagnosis for patients with mild nutritional states,and the correlation with the BODE index is weak.Thus,it is not suitable nutritional evaluation for all patients with COPD.Furthermore,NUFFE-CHI is an acceptable tool that correlation with the BODE index is more reliable.The entry does not involve any indicators that need to be measured.It is suitable for elderly people to understand and fill in,and it cannot meet the needs of monitoring anthropometric indicators in clinical practice.Patients with COPD may not be able to accurately review the weight changes in the past 3months,they can use NUFFE-CHI nutritional evaluation.