Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease

• Published in: British Journal of Nutrition
• Main Authors: Ingadottir, Arora Ros, Beck, Anne M., Baldwin, Christine, Weekes, C. Elizabeth, Geirsdottir, Olof, Ramel, Alfons, Gislason, Thorarinn, Gunnarsdottir, Ingibjorg
• Other Authors: Matvæla- og næringarfræðideild (HÍ), Faculty of Food Science and Nutrition (UI), Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Cambridge University Press (CUP) 2018
• Subjects: Malnutrition; Chronic obstructive pulmonary disease; Mortality; Readmission; Length of stay; Fat free mass index; Length of hospital stay; Oral nutritional supplements; Næringarskortur; Lungnasjúkdómar; Dánartíðni; Sjúkrahúsvist; Iceland
• Online Access: https://hdl.handle.net/20.500.11815/1928; https://doi.org/10.1017/S0007114517003919

Publisher's version (útgefin grein) Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015–March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1–5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes. The authors acknowledge the staff at the Thoracic ward and the Thoracic outpatient’s clinic at Landspitali National University Hospital, Reykjavik, Iceland, and Eva Bjorg Bjorgvinsdottir for their contribution to the data collection. This study was funded by the Icelandic Research Fund of the Icelandic Centre for ...