Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease

Mitja Lainscak, Stephan von Haehling, Wolfram Doehner, Irena Sarc, Tina Jeric, Kristina Ziherl, Mitja Kosnik, Stefan D. Anker, Stanislav Suskovic

Research output: Contribution to journalArticle

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Abstract

Background: Nutritional status, weight loss and cachexia have important prognostic implications in patients with chronic obstructive pulmonary disease (COPD). Body mass index (BMI) has been implicated in COPD risk assessment, but information is mostly limited to composite scores or to patients with stable disease. We aimed to analyse the association between BMI and mortality in acute exacerbation of COPD. Methods: This retrospective survey included 968 patients hospitalized due to acute exacerbation of COPD at the University Clinic Golnik from February 2002 to June 2007. Vital status was ascertained with Central Population Registry, and database was censored on November 1, 2008. Results: Median BMI was 25. 08 kg/m2 (interquartile range, 21. 55-29. 05 kg/m2) and 210 patients (22%) had BMI <21 kg/m2. During median follow-up of 3. 26 years (1. 79-4. 76 years), 430 patients (44%) died. Lowest mortality was found for BMI 25. 09-29. 05 kg/m2. When divided per BMI decile, mortality was lowest for BMI 25. 09-26. 56 kg/m2 (33%). In univariate analysis, BMI per quartile and BMI per unit increase were predictive for all-cause mortality. In an adjusted model, BMI per 1 kg/m2 unit increase was associated with 5% less chance of death (hazard ratio 0. 95, 95% confidence interval 0. 93-0. 97). Conclusions: Low BMI <21 kg/m2 is frequent in patients hospitalized due to acute exacerbation of COPD. Higher BMI was independently predictive of better long-term survival. A better outcome in obese patients compared to normal weight is in contrast to primary prevention data but concurs with observations of an obesity paradox in other cardiovascular diseases.

Original languageEnglish
Pages (from-to)81-86
Number of pages6
JournalJournal of Cachexia, Sarcopenia and Muscle
Volume2
Issue number2
DOIs
Publication statusPublished - 2011

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Chronic Obstructive Pulmonary Disease
Body Mass Index
Mortality
Cachexia
Primary Prevention
Nutritional Status
Registries
Weight Loss
Cardiovascular Diseases
Obesity
Databases
Confidence Intervals
Weights and Measures
Survival

Keywords

  • Body mass index
  • Cachexia
  • Chronic obstructive pulmonary disease
  • Survival

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physiology (medical)

Cite this

Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease. / Lainscak, Mitja; von Haehling, Stephan; Doehner, Wolfram; Sarc, Irena; Jeric, Tina; Ziherl, Kristina; Kosnik, Mitja; Anker, Stefan D.; Suskovic, Stanislav.

In: Journal of Cachexia, Sarcopenia and Muscle, Vol. 2, No. 2, 2011, p. 81-86.

Research output: Contribution to journalArticle

Lainscak, M, von Haehling, S, Doehner, W, Sarc, I, Jeric, T, Ziherl, K, Kosnik, M, Anker, SD & Suskovic, S 2011, 'Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease', Journal of Cachexia, Sarcopenia and Muscle, vol. 2, no. 2, pp. 81-86. https://doi.org/10.1007/s13539-011-0023-9
Lainscak, Mitja ; von Haehling, Stephan ; Doehner, Wolfram ; Sarc, Irena ; Jeric, Tina ; Ziherl, Kristina ; Kosnik, Mitja ; Anker, Stefan D. ; Suskovic, Stanislav. / Body mass index and prognosis in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease. In: Journal of Cachexia, Sarcopenia and Muscle. 2011 ; Vol. 2, No. 2. pp. 81-86.
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abstract = "Background: Nutritional status, weight loss and cachexia have important prognostic implications in patients with chronic obstructive pulmonary disease (COPD). Body mass index (BMI) has been implicated in COPD risk assessment, but information is mostly limited to composite scores or to patients with stable disease. We aimed to analyse the association between BMI and mortality in acute exacerbation of COPD. Methods: This retrospective survey included 968 patients hospitalized due to acute exacerbation of COPD at the University Clinic Golnik from February 2002 to June 2007. Vital status was ascertained with Central Population Registry, and database was censored on November 1, 2008. Results: Median BMI was 25. 08 kg/m2 (interquartile range, 21. 55-29. 05 kg/m2) and 210 patients (22{\%}) had BMI <21 kg/m2. During median follow-up of 3. 26 years (1. 79-4. 76 years), 430 patients (44{\%}) died. Lowest mortality was found for BMI 25. 09-29. 05 kg/m2. When divided per BMI decile, mortality was lowest for BMI 25. 09-26. 56 kg/m2 (33{\%}). In univariate analysis, BMI per quartile and BMI per unit increase were predictive for all-cause mortality. In an adjusted model, BMI per 1 kg/m2 unit increase was associated with 5{\%} less chance of death (hazard ratio 0. 95, 95{\%} confidence interval 0. 93-0. 97). Conclusions: Low BMI <21 kg/m2 is frequent in patients hospitalized due to acute exacerbation of COPD. Higher BMI was independently predictive of better long-term survival. A better outcome in obese patients compared to normal weight is in contrast to primary prevention data but concurs with observations of an obesity paradox in other cardiovascular diseases.",
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AU - Jeric, Tina

AU - Ziherl, Kristina

AU - Kosnik, Mitja

AU - Anker, Stefan D.

AU - Suskovic, Stanislav

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AB - Background: Nutritional status, weight loss and cachexia have important prognostic implications in patients with chronic obstructive pulmonary disease (COPD). Body mass index (BMI) has been implicated in COPD risk assessment, but information is mostly limited to composite scores or to patients with stable disease. We aimed to analyse the association between BMI and mortality in acute exacerbation of COPD. Methods: This retrospective survey included 968 patients hospitalized due to acute exacerbation of COPD at the University Clinic Golnik from February 2002 to June 2007. Vital status was ascertained with Central Population Registry, and database was censored on November 1, 2008. Results: Median BMI was 25. 08 kg/m2 (interquartile range, 21. 55-29. 05 kg/m2) and 210 patients (22%) had BMI <21 kg/m2. During median follow-up of 3. 26 years (1. 79-4. 76 years), 430 patients (44%) died. Lowest mortality was found for BMI 25. 09-29. 05 kg/m2. When divided per BMI decile, mortality was lowest for BMI 25. 09-26. 56 kg/m2 (33%). In univariate analysis, BMI per quartile and BMI per unit increase were predictive for all-cause mortality. In an adjusted model, BMI per 1 kg/m2 unit increase was associated with 5% less chance of death (hazard ratio 0. 95, 95% confidence interval 0. 93-0. 97). Conclusions: Low BMI <21 kg/m2 is frequent in patients hospitalized due to acute exacerbation of COPD. Higher BMI was independently predictive of better long-term survival. A better outcome in obese patients compared to normal weight is in contrast to primary prevention data but concurs with observations of an obesity paradox in other cardiovascular diseases.

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