uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Lungmedicin och Allergologi)
Show others and affiliations
2007 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 101, no 9, 1954-1960 p.Article in journal (Refereed) Published
Abstract [en]

Patients with chronic obstructive pulmonary disease (COPD) often have difficulties with keeping their weight. The aim of this investigation was to study nutritional status in hospitalised Nordic COPD patients and to investigate the association between nutritional status and long-term mortality in this patient group. In a multicentre study conducted at four university hospitals (Reykjavik, Uppsala, Tampere and Copenhagen) hospitalised patients with COPD were investigated. Patient height, weight and lung function was recorded. Health status was assessed with St. George's Hospital Respiratory Questionnaire. After 2 years, mortality data was obtained from the national registers in each country. Of the 261 patients in the study 19% where underweight (BMI <20), 41% were of normal weight (BMI 20-25), 26% were overweight (BMI 25-30) and 14% were obese. FEV1 was lowest in the underweight and highest in the overweight group (p = 0.001) whereas the prevalence of diabetes and cardio-vascular co-morbidity went the opposite direction. Of the 261 patients 49 (19%) had died within 2 years. The lowest mortality was found among the overweight patients, whereas underweight was related to increased overall mortality. The association between underweight in COPD-patients, and mortality remained significant after adjusting for possible confounders such as FEV1 (hazard risk ratio (95% CI) 2.6 (1.3-5.2)). We conclude that COPD patients that are underweight at admission to hospital have a higher risk of dying within the next 2 years. Further studies are needed in order to show whether identifying and treating weight loss and depletion of fat-free mass (FFM) is a way forward in improving the prognosis for hospitalised COPD patients.

Place, publisher, year, edition, pages
2007. Vol. 101, no 9, 1954-1960 p.
Keyword [en]
Lung disease, Bronchus disease, Respiratory disease, Chronic disease, Pneumology, Chronic, Patient, Human, Hospitalization, Prognosis, Mortality, Epidemiology, Long term, Nutritional status, Obstructive pulmonary disease
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-97937DOI: 10.1016/j.rmed.2007.04.009ISI: 000249092300014PubMedID: 17532198OAI: oai:DiVA.org:uu-97937DiVA: diva2:173062
Available from: 2008-12-22 Created: 2008-12-22 Last updated: 2011-01-25Bibliographically approved
In thesis
1. Nutritional Depletion in Chronic Obstructive Pulmonary Disease (COPD): Effect on Morbidity, Mortality and Physical Capacity
Open this publication in new window or tab >>Nutritional Depletion in Chronic Obstructive Pulmonary Disease (COPD): Effect on Morbidity, Mortality and Physical Capacity
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this work was to examine the effects of depleted nutritional status on some aspects of Chronic Obstructive Pulmonary Disease (COPD).

Morbidity. In paper І, we found that energy intake was lower than the calculated energy demand for all patients. A low body mass index (BMI) at inclusion and weight loss, during the one year follow-up period were independent risk factors for having a new exacerbation (p = 0.003 and 0.006, respectively).

Mortality. Nineteen percent of the patients in paper ІІ, where underweight (BMI<20). A significant positive correlation was found between BMI and FEV1, and this correlation remained significant after adjustment for age, sex and pack years (p<0.0001). Being underweight was related to increased overall mortality and respiratory mortality but not to mortality of other causes, 19% of the patients had died within 2 years. The lowest mortality was found among the overweight patients (BMI 25-30 kg/m).

Physical capacity and effect of training. In paper ІІІ we investigated baseline characteristics of patients that were starting physical training. We found that peak working capacity was positively related to BMI (r=0.35, p=0.02) and fat free mass index (FFMI) (r=0.49, p=0.004) and negatively related to S-Fibrinogen and serum C reactive protein (S-CRP). BMI and FFMI were significantly related to the 12 minutes walking distance when adjusted for body weight. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV1, FFMI and CRP were combined in a multiple regression model.

In Paper ІV the median change in fat free mass (FFM), after 4 months of physical training was 0.5 kg. Old age, low FEV1 and high level of dyspnoea were independent negative predictors of FFM increase after the training period.

In conclusion nutritional status is an important determinant of morbidity, mortality and physical capacity in COPD. Low FEV1 and high level of dyspnea are negative predictors for increased FFM after physical training.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 55 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 411
chronic obstructive pulmonary disease, nutrition, pulmonary rehabilitation, physical capasity, systemic inflammation
National Category
Respiratory Medicine and Allergy
urn:nbn:se:uu:diva-9512 (URN)978-91-554-7381-5 (ISBN)
Public defence
2009-01-16, Roberg salen, A9, Ing 40, 5 tr, Akademiska sjukhuset, Uppsala, 09:15
Available from: 2008-12-22 Created: 2008-12-22Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Hallin, RunaLindberg, EvaJanson, Christer
By organisation
Department of Medical Sciences
In the same journal
Respiratory Medicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 162 hits
ReferencesLink to record
Permanent link

Direct link