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The Impact of Malnutrition on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: The Predictive Value of the Mini Nutritional Assessment (MNA) Versus Acute Exacerbations in Patients with Highly Complex COPD and Its Clinical and Prognostic Implications
by
Domenico Di Raimondo
Domenico Di Raimondo 1,2,*,†
,
Edoardo Pirera
Edoardo Pirera 1,†
,
Chiara Pintus
Chiara Pintus 1,
Riccardo De Rosa
Riccardo De Rosa 1,
Martina Profita
Martina Profita 1,
Gaia Musiari
Gaia Musiari 1,2,
Gherardo Siscaro
Gherardo Siscaro 3 and
Antonino Tuttolomondo
Antonino Tuttolomondo 1,2
1
Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (ProMISE) “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy
2
PhD Programme “Molecular and Clinical Medicine”, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (ProMISE) “G. D’Alessandro”, University of Palermo, Piazza Delle Cliniche 2, 90127 Palermo, Italy
3
Medical Affairs—Chiesi Italy SpA, 43122 Parma, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Nutrients 2024, 16(14), 2303; https://doi.org/10.3390/nu16142303 (registering DOI)
Submission received: 19 June 2024
/
Revised: 13 July 2024
/
Accepted: 15 July 2024
/
Published: 17 July 2024
Abstract
Background: Current management of COPD is predominantly focused on respiratory aspects. A multidimensional assessment including nutritional assessment, quality of life and disability provides a more reliable perspective of the true complexity of COPD patients. Methods: This was a prospective observational study of 120 elderly COPD patients at high risk of acute exacerbations. The Mini Nutritional Assessment (MNA) was administered in addition to the usual respiratory assessment. The primary outcome was a composite of moderate or severe acute exacerbations during 52 weeks of follow-up. Results: The median MNA Short Form (SF) score was 11 (8–12), 39 participants (32.50%) had a normal nutritional status, 57 (47.5%) were at risk of malnutrition and 24 (20%) were malnourished. Our multivariate linear regression models showed that the MNA score was associated with dyspnea and respiratory symptom severity, assessed by the Modified British Medical Research Council (mMRC) scale and the COPD Assessment Test (CAT) score, with spirometric variables, in particular with the severity of airflow limitation based on the value of FEV1, and with poorer QoL, as assessed by the EQ-5D-3 questionnaire. Competing risk analysis according to nutritional status based on the MNA Total Score showed that COPD participants “at risk of malnutrition” and “malnourished” had a higher risk of moderate to severe acute exacerbations with sub-hazard ratios of 3.08 (1.40–6.80), p = 0.015, and 4.64 (1.71–12.55), p = 0.0002, respectively. Conclusion: Our study confirms the importance of assessing nutritional status in elderly COPD patients and its prognostic value.
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MDPI and ACS Style
Di Raimondo, D.; Pirera, E.; Pintus, C.; De Rosa, R.; Profita, M.; Musiari, G.; Siscaro, G.; Tuttolomondo, A.
The Impact of Malnutrition on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: The Predictive Value of the Mini Nutritional Assessment (MNA) Versus Acute Exacerbations in Patients with Highly Complex COPD and Its Clinical and Prognostic Implications. Nutrients 2024, 16, 2303.
https://doi.org/10.3390/nu16142303
AMA Style
Di Raimondo D, Pirera E, Pintus C, De Rosa R, Profita M, Musiari G, Siscaro G, Tuttolomondo A.
The Impact of Malnutrition on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: The Predictive Value of the Mini Nutritional Assessment (MNA) Versus Acute Exacerbations in Patients with Highly Complex COPD and Its Clinical and Prognostic Implications. Nutrients. 2024; 16(14):2303.
https://doi.org/10.3390/nu16142303
Chicago/Turabian Style
Di Raimondo, Domenico, Edoardo Pirera, Chiara Pintus, Riccardo De Rosa, Martina Profita, Gaia Musiari, Gherardo Siscaro, and Antonino Tuttolomondo.
2024. "The Impact of Malnutrition on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: The Predictive Value of the Mini Nutritional Assessment (MNA) Versus Acute Exacerbations in Patients with Highly Complex COPD and Its Clinical and Prognostic Implications" Nutrients 16, no. 14: 2303.
https://doi.org/10.3390/nu16142303
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