scholarly journals Differences in the Outcome of Patients with COPD according to Body Mass Index

2020 ◽  
Vol 9 (3) ◽  
pp. 710 ◽  
Author(s):  
Zichen Ji ◽  
Javier de Miguel-Díez ◽  
Christian Reynaldo Castro-Riera ◽  
José María Bellón-Cano ◽  
Virginia Gallo-González ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Hospital Admissions ◽  
Obesity Paradox ◽  
Chronic Obstructive ◽  
P Value ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Critical Unit

Background: In chronic obstructive pulmonary disease (COPD), the “obesity paradox” is a phenomenon without a clear cause. The objective is to analyze the complications of COPD patients according to their body mass index (BMI). Methods: An observational study with a six-year prospective follow-up of 273 COPD patients who attended a spirometry test in 2011. Survival and acute events were analyzed according to the BMI quartiles. Results: A total of 273 patients were included. BMI quartiles were ≤24.23; 24.24–27.69; 27.70–31.25; ≥31.26. During the follow-up, 93 patients died. No differences were found in exacerbations, pneumonia, emergency visits, hospital admissions or income in a critical unit. Survival was lower in the quartile 1 of BMI with respect to each of the 2–4 quartiles (p-value 0.019, 0.013, and 0.004, respectively). Advanced age (hazard ratio, HR 1.06; 95% confidence interval, CI 1.03–1.09), low pulmonary function (HR 0.93; 95% CI 0.86–0.99), exacerbator with chronic bronchitis phenotype (HR 1.76; 95% CI 1.01–3.06), high Charlson (HR 1.32, 95% CI 1.18–1.49), and the quartile 1 of BMI (HR 1.99, 95% CI 1.08–3.69) were identified as risk factors independently associated with mortality. Conclusions: In COPD, low BMI conditions a lower survival, although not for having more acute events.

Impact of Body Mass Index Change on the Prognosis of Chronic Obstructive Pulmonary Disease

Respiration ◽  
2020 ◽  
pp. 1-11
Author(s):  
Eun Kyung Kim ◽  
Dave Singh ◽  
Joo Hun Park ◽  
Yong Bum Park ◽  
Seung-Il Kim ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Mass Index ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Longitudinal Change ◽  
Chronic Obstructive ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

<b><i>Background:</i></b> Low body mass index (BMI) is an important prognostic factor in chronic obstructive pulmonary disease (COPD). However, the prognostic value of longitudinal BMI change in COPD has not been well studied. <b><i>Objective:</i></b> We aimed to evaluate the association between longitudinal change of BMI and prognosis of COPD in Korean COPD cohort. <b><i>Methods:</i></b> This study was conducted in a prospective Korean Obstructive Lung Disease (KOLD) cohort where COPD patients were recruited on an outpatient basis at 17 hospitals in South Korea. Annual BMI was measured over a period of 3 years or more. All patients were categorized into underweight (UW), normal weight (NW), and overweight (OW) groups by BMI. Clinical characteristics and outcomes including exacerbation and mortality were compared based on initial BMI grade and longitudinal change of BMI. <b><i>Results:</i></b> This analysis included 537 COPD patients (mean age = 67.4 ± 7.9 years, male = 97.0%, mean BMI = 23.0 ± 3.1) of KOLD cohort. The proportions of UW, NW, and OW groups were 6.9% (<i>n</i> = 37), 68.9% (<i>n</i> = 370), and 24.2% (<i>n</i> = 130) respectively. The UW group showed lower forced expiratory volume in 1 s (FEV<sub>1</sub>) (<i>p</i> &#x3c; 0.001), shorter 6-minute walk distance (<i>p</i> &#x3c; 0.001), higher modified Medical Research Council score (<i>p</i> = 0.002), higher St. George Respiratory Questionnaire score (<i>p</i> &#x3c; 0.001), higher emphysema index (<i>p</i> &#x3c; 0.001) and air-trapping index (<i>p</i> &#x3c; 0.001), and more frequent (<i>p</i> &#x3c; 0.001) and severe exacerbations (<i>p</i> = 0.003). Multivariable analyses demonstrated that decrease of BMI (hazard ratio [HR] = 0.786, <i>p</i> = 0.038) and the descent of BMI group (HR = 3.167, <i>p</i> = 0.016) at 3-year follow-up along with age, initial BMI, post-bronchodilator FEV<sub>1</sub>, and severe exacerbations were significantly associated with mortality. <b><i>Conclusions:</i></b> This study demonstrated that BMI decrease during follow-up was independently associated with exacerbation and higher mortality of COPD, suggesting BMI reduction in COPD should be carefully managed.

Association body mass index and spirometric lung function in chronic obstructive pulmonary disease (COPD) patients attending RIMS Hospital, Manipur

2014 ◽  
Vol 28 (3) ◽  
pp. 157 ◽  
Author(s):  
AwungshiJannie Shimray ◽  
WangkheimayumAsoka Singh ◽  
Kanmi Ningshen ◽  
Wangkheimayum Kanan ◽  
AshemNandarani Devi ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Body Mass Index ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

P3781Prognostic impact of body mass index on mortality and its causes in patients with atrial fibrillation: the Fushimi AF Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y An ◽  
M Iguchi ◽  
M Ishii ◽  
N Masunaga ◽  
Y Aono ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Obesity Paradox ◽  
Chronic Obstructive ◽  
Inverse Association ◽  
Community Based ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Obesity has been shown to be related to an increased risk for incidence and progression of atrial fibrillation (AF). Meanwhile, the inverse association between body mass index (BMI) and mortality, so-called “obesity paradox”, is well-known among patients with AF, as well as other cardiovascular diseases. However, data regarding the relationship between BMI and specific causes of death in AF patients remain scarce. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto. The inclusion criterion for the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time. We started to enroll patients from March 2011, and baseline characteristics including BMI and follow-up data were available for 3,805 patients by the end of November 2018. Patients were categorized into 3 groups depending on the BMI value; underweight (<18.5 kg/m2; 419 patients), normal (18.5 to <25.0 kg/m2; 2,283 patients), overweight (≤25.0 kg/m2; 1,103 patients). Results In the entire population, the mean BMI level was 23.1±4.0 kg/m2. The lower BMI was associated with higher age (78.5±10.3, 74.0±10.3, and 71.3±10.9 years in Underweight, Normal, and Overweight, respectively; p<0.001) and with higher prevalence of various comorbidities and CHA2DS2-VASc scores (3.83±1.67, 3.43±1.70, and 3.29±1.64, p<0.001). Oral anticoagulants were less frequently prescribed in those with lower BMI (46%, 56%, and 58%, p<0.001). During a median follow-up of 1,464 days (interquartile range: 727–2,228 days), all-cause mortality was lower in accordance with higher BMI (14.3, 5.3, and 3.5 per 100 person-years, respectively; p<0.001). The proportion of infection as a cause of death was prominently higher in the Underweight group than the others (25.7%, 16.7%, and 13.4%, p<0.001) (Figure A). Furthermore, the mortality due to infection was consistently higher in Underweight than in the others in any of the age subgroups (Figure B). Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the BMI value for mortality, adjusted by age, sex, chronic kidney disease, anemia, chronic obstructive pulmonary disease, history of major bleeding, and other components of CHA2DS2-VASc score. Higher BMI was related to lower all-cause mortality (per 5 kg/m2 increase: HR 0.71 [95% CIs 0.63–0.78], p<0.001), and also lower mortality due to infection (per 5 kg/m2 increase: HR 0.48 [95% CIs 0.37–0.61], p<0.001). Figure 1 Conclusions In a Japanese community-based AF cohort, obesity paradox was also observed on all-cause mortality. In particular, lower BMI was strongly associated with the mortality due to infection regardless of age. Acknowledgement/Funding Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi-Sankyo, Novartis Pharma, MSD, Sanofi-Avent

Abstract 15852: Body Mass Index and Fatal Outcome in Patients Hospitalized for Covid 19

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gursukhman Sidhu ◽  
Saihariharan Nedunchezhian ◽  
Laura Padilla-Carrasquillo ◽  
nitin sabharwal ◽  
Seyed Khalafi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Medical Center ◽  
Fatal Outcome ◽  
Hospital Death ◽  
Chronic Obstructive ◽  
P Value ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Disease Mortality

Introduction: Obesity may affect COVID-19 outcomes, independent of its association with hypertension, diabetes, chronic obstructive pulmonary disease and other cardiovascular disease. Hypothesis: Is obesity a major determinant of morbidity and mortality in patients with COVID-19? Methods: Retrospective analysis of all confirmed COVID-19 patients hospitalized at University Medical Center in New Orleans, Louisiana between February 1, 2020 to May 1, 2020 was performed. Intensive care unit (ICU) stay and fatal outcomes were analyzed as a function of body mass index (BMI), hypertension, diabetes, hyperlipidemia, and CKD. Risk factors for fatal outcomes were evaluated. Multivariate logistic regression was used to determine odds ratios. P-Value was set at 0.05. Results: From a sample size of 419 patients, 60(14.3%) were admitted to the ICU. Amongst ICU admits, 85% were African American (AA), 61.6% had BMI >30, 48.3% had diabetes, and 30% had chronic kidney disease. Mortality was 91.6% after ICU admission. Out of a total of 419, mortality was the highest in admits with BMI < 25(20.2%) and with BMI >40(20.3%). BMI > 40 was associated with a higher odds of death (Odds ratio: 3.9, 95% Confidence Interval (CI) 1.45-10.5) and ICU admission (OR:3.2 95% CI 1.1-9) after adjustment for age, race, sex and comorbidities. Conclusion: A direct association exists for BMI > 40 and in-hospital death, independent of comorbidities. Caution with aggressive intervention is warranted for such patients on presentation.

scholarly journals Effectiveness of pneumococcal vaccine in patients with chronic obstructive pulmonary disease (COPD)

2018 ◽  
Vol 6 (11) ◽  
pp. 3698
Author(s):  
Thitta Mohanty ◽  
Mahismita Patro ◽  
Jyotirmaya Sahoo ◽  
Bijaya Kumar Meher ◽  
Manoranjan Pattnaik ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pneumococcal Vaccine ◽  
Controlled Trial ◽  
Airflow Obstruction ◽  
Chronic Obstructive ◽  
P Value ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Pneumococcal infections are frequent cause chronic obstructive pulmonary disease (COPD) exacerbations and though various guidelines recommend the use of pneumococcal vaccines routinely to COPD patients to prevent exacerbations, the data regarding the effectiveness of this vaccine is limited and contradictory. Aims and objectives was to compare the frequency of exacerbations in patients of COPD before and after administration of pneumococcal vaccine and to find out the frequency of exacerbations in patients of COPD who are vaccinated against those who are not vaccinated as well as to study the effectiveness of pneumococcal vaccine will be analysed in respect to age, sex, Body mass index (BMI), severity of disease and other co-morbidity.Methods: This was a randomized non-placebo controlled trial, conducted from September 2013 to August 2015 including total of 150 patients divided into two groups: cases and controls. The cases were administered PPV23 along with specific medication and were followed up at intervals of 3months. Exacerbations were identified based on ANTHONISEN’S criteria. Number of exacerbations in each follow-up was recorded. The data from both the groups were analysed statistically.Results: After 1 year of follow up, there was significant reduction in mean number of exacerbations (p value <0.0001) in patients with COPD in vaccinated group. PPV23 was more effective in patients with COPD of less than 65 years of age and with severe and/or very severe airflow obstruction and also in patients with lower BMI (≤21kg/m2), females and with co-morbidities.Conclusions: This is an important strategy to prevent the repeated exacerbations in COPD patients particularly in severe and very severe disease groups and we support the recommendation that pneumococcal vaccine should be administered to these patients.

A COMPARATIVE STUDY OF ABG PATTERN IN PATIENTS OF COPD WITH OR WITHOUT COR PULMONALE

2021 ◽  
pp. 64-66
Author(s):  
Md Shoeb Alam ◽  
Rahul Ranjan ◽  
V N Jha
Keyword(s):  
Hypoxic Pulmonary Vasoconstriction ◽  
Respiratory Acidosis ◽  
Public Health Problem ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
P Value ◽  
Major Public Health Problem ◽  
Close Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major public health problem. COR PULMONALE describes the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or increased pulmonary artery pressure. Hypoxic pulmonary vasoconstriction, hypercapnia, respiratory acidosis and pulmonary vascular remodeling in COPD can cause an increase in right ventricular (RV) after load, which in turn, results in RVfailure leading to COR PULMONALE AIM:The purpose of the study is to compare the ABG pattern in patients of COPD with or without COR PULMONALE. MATERIALS AND METHODS: This prospective observational study was conducted in the Department of Medicine of DMCH, Laheriasarai, Bihar. The study was conducted with duration of 2 years. Atotal of 100 patients admitted as a case of COPD with or without COR PULMONALE. The patients were put into two subgroups, COPD with and without COR PULMONALE. RESULT: The mean duration was 10.17 years and 9.20 years respectively in patients with and without COR PULMONALE. There was no statistically signicant difference regarding mean duration of disease (p value =0.304). Mean CAT score was 16.59 ± 6.26 and mean mMRC was 3.19± 0.45 in COPD patients with COR PULMONALE group. Mean CAT score was 14.06 ± 4.46 and mean mMRC was 3.10 ± 0.44 in COPD patients without COR PULMONALE group. We found no signicant difference among these variables between groups. Although COR PULMONALE patients had higher CATscore and mMRC score, the difference was not signicant (p value = >0.05). CONCLUSION:ABG ANALYSIS should be recommended for all patients of COPD with or without COR PULMONALE to assess the degree of hypoxemia, hypercapnea, respiratory acidosis and also, we can identify individuals who need more close monitoring and intensive treatment.

scholarly journals EVALUATION OF THE QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN OVERWEIGHT PATIENTS

2020 ◽  
Vol 73 (8) ◽  
pp. 1668-1670
Author(s):  
Mykola M. Ostrovskyy ◽  
Nadiia V. Korzh
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Pathological Process ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

The aim: To evaluate the effect of overweight on the quality of life of chronic obstructive pulmonary disease (COPD) patients GOLD III. Materials and methods: 65 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). Patients’ quality of life was evaluated with the help of standardized St.George’s Respiratory Questionnaire (SGRQ). Results: The study revealed changes in the PF indices and the decrease in quality of life in overweight patients, especially in case of destabilization of the pathological process. Conclusions: The obtained results show that overweight is the underlying condition for more severe course of the pathology and requires further study of its impact on the health and quality of life of patients in order to improve the effectiveness of treatment.

scholarly journals Long-term Effects of Telemonitoring on Healthcare Usage in Patients with Heart Failure or COPD (Preprint)

2018 ◽  
Author(s):  
Jorien Maria Margaretha van der Burg ◽  
Nasir Ahmad Aziz ◽  
Maurits C. Kaptein ◽  
Martine J.M. Breteler ◽  
Joris H. Jansen ◽  
...  
Keyword(s):  
Heart Failure ◽  
The Netherlands ◽  
Healthcare Costs ◽  
Hospital Admissions ◽  
Disease Stage ◽  
Chronic Obstructive ◽  
Home Telemonitoring ◽  
Copd Patients ◽  
Patients With Heart Failure

UNSTRUCTURED Objective The aim of this study was to evaluate the effectiveness of home telemonitoring in reducing healthcare usage and costs in patients with heart failure or chronic obstructive pulmonary disease (COPD). Design The study was a retrospective observational study with a pre-post research design and a follow-up duration of up to 3 years, based on hospital data collected in the period 2012-2016. Setting Data was collected at the Slingeland Hospital in Doetinchem, The Netherlands. Participants In 2012 the Slingeland Hospital in The Netherlands started a telemonitoring program for patients with COPD or heart failure as part of their usual care. Patients were eligible for the telemonitoring program if they were in an advanced disease stage (New York Heart Association (NYHA) functional class 3 or 4; COPD gold stage 3 or 4), received treatment for their condition by a cardiologist or pulmonary specialist at the Slingeland Hospital, were proficient in Dutch and capable of providing informed consent. Exclusion criteria were absence of the cognitive, physical or logistical ability required to fully participate in the program. Hundred seventy-seven patients with heart failure and 83 patients with COPD enrolled the program between 2012 and 2016. Intervention Using a touchscreen, participants with heart failure recorded their weight (daily), blood pressure and heart rate (once a week) through connected instruments, and completed a questionnaire about their symptoms (once a week). Symptoms in patients with COPD were monitored via the Clinical COPD Questionnaire (CCQ), which participants were asked to complete twice per week. All home registrations were sent via a telemonitoring application (cVitals, FocusCura, Driebergen-Rijssenburg) on the iPad to a medical service center were a trained nurse monitored the data and contacted the patient by video chat or a specialised nurse in the hospital in case of abnormal results, such as deviations from a preset threshold or alterations in symptom score. Outcome measures The primary outcome was the number of hospitalisations; the secondary outcomes were total number of hospitalisation days and healthcare costs during the follow-up period. Generalised Estimating Equations were applied to account for repeated measurements, adjusting for sex, age and length of follow-up. Results In heart failure patients (N=177), after initiation of home telemonitoring both the number of hospitalisations and the total number of hospitalisation days significantly decreased (incidence rate ratio of 0.35 (95% CI: 0.26-0.48) and 0.35 (95% CI: 0.24-0.51), respectively), as did the total healthcare costs (exp(B) = 0.11 (95% CI: 0.08-0.17)), all p < 0.001. In COPD patients (N=83) neither the number of hospitalisations nor the number of hospitalisation days changed compared to the pre-intervention period. However, the average healthcare costs were about 54% lower in COPD patients after the start of the home telemonitoring intervention (exp(B) = 0.46, 95% CI 0.25-0.84, p = 0.011). Conclusion Integrated telemonitoring significantly reduced the number of hospital admissions and days spent in hospital in patients with heart failure, but not in patients with COPD. Importantly, in both patients with heart failure and COPD the intervention substantially reduced the total healthcare costs.

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