Three nutritional indices are effective predictors of all-cause mortality in patients with chronic obstructive pulmonary disease

Mai Suying, Nan Yayun, Wang Wei, Wu Yuanbo, Chen Qiong

PDF(829 KB)
PDF(829 KB)
Journal of Chongqing Medical University ›› 2025, Vol. 50 ›› Issue (03) : 344-351. DOI: 10.13406/j.cnki.cyxb.003653
Clinical research

Three nutritional indices are effective predictors of all-cause mortality in patients with chronic obstructive pulmonary disease

Author information +
History +

Abstract

Objective Malnutrition is prevalent among patients with chronic obstructive pulmonary disease(COPD) and closely associated with adverse outcomes. This study aimed to evaluate the effectiveness of three nutritional indices in predicting all-cause mortality among COPD patients. Methods Based on the National Health and Nutrition Examination Survey(NHANES),this study included 1640 patients with COPD surveyed from 1999 to 2018. The optimal cutoff values for controlling nutritional status(CONUT) score,geriatric nutritional risk index(GNRI),and prognostic nutritional index(PNI) were determined using receiver operating characteristic curves. The predictive value of these nutritional indices was assessed using the area under the receiver operating characteristic curve and C-index. Their predictive abilities were compared using the net reclassification improvement and integrated discrimination improvement. A Cox regression analysis was conducted to explore the association of the three nutritional indices with all-cause mortality. Results Log-rank tests revealed lower overall survival rates in patients with higher nutritional risks(P<0.001). In multivariate Cox regression adjusting for all covariates,CONUT score(hazard ratio [HR=1.31,95%CI=1.03-1.67,P=0.030),GNRI(HR=2.02,95%CI=1.26-3.24,P=0.004),and PNI(HR=2.05,95%CI=1.53-2.75,P<0.001) were independently associated with all-cause mortality. Conclusion This study confirms that the three nutritional indices are effective predictors of all-cause mortality in COPD patients. Compared with PNI,CONUT score and GNRI demonstrate improved predictive abilities,and they are recommended for routine screening for high-risk malnutrition in COPD patients.

Key words

chronic obstructive pulmonary disease / malnutrition / all-cause mortality / nutrition assessment / NHANES database

Cite this article

Download Citations
Mai Suying , Nan Yayun , Wang Wei , et al . Three nutritional indices are effective predictors of all-cause mortality in patients with chronic obstructive pulmonary disease. Journal of Chongqing Medical University. 2025, 50(03): 344-351 https://doi.org/10.13406/j.cnki.cyxb.003653

References

1
Agustí A Celli BR Criner GJ,et al. Global initiative for chronic obstructive lung disease 2023 report:gold executive summary[J]. Eur Respir J202361(4):2300239.
2
Organization WH. The top 10 causes of death [J]. 2019.
3
琚 慧,唐 玲. 老年综合征研究进展[J]. 护理研究202034(12):2160-2165.
Ju H Tang L. Progress in research on aging syndrome[J]. Chin Nurs Res202034(12):2160-2165.
4
Zhao T Chen JY Li XY,et al. Malnutrition associated with readmission in elderly patients with chronic obstructive pulmonary disease[J]. Chin Med J2023136(3):357-359.
5
Deng MM Lu Y Zhang Q,et al. Global prevalence of malnutrition in patients with chronic obstructive pulmonary disease:systemic review and meta-analysis[J]. Clin Nutr202342(6):848-858.
6
Keogh E Williams EM. Managing malnutrition in COPD:a review[J]. Respir Med2021176:106248.
7
Cederholm T Jensen GL Correia MITD,et al. GLIM criteria for the diagnosis of malnutrition-A consensus report from the global clinical nutrition community[J]. J Cachexia Sarcopenia Muscle201910(1):207-217.
8
杨珍珍,彭 瑜,张钲. 营养状态评估与心血管疾病关系的研究进展[J]. 心血管康复医学杂志201827(5):599-602.
Yang ZZ Peng Y Zhang Z. Research progress of relationship between nutritional status and cardiovascular disease[J]. Chin J Cardiovasc Rehabil Med201827(5):599-602.
9
Ignacio de Ulíbarri J González-Madroño A de Villar NG,et al. CONUT:a tool for controlling nutritional status. First validation in a hospital population[J]. Nutr Hosp200520(1):38-45.
10
Bouillanne O Morineau G Dupont C,et al. Geriatric Nutritional Risk Index:a new index for evaluating at-risk elderly medical patients[J]. Am J Clin Nutr200582(4):777-783.
11
Alvares-da-Silva MR Reverbel da Silveira T. Comparison between handgrip strength,subjective global assessment,and prognostic nutritional index in assessing malnutrition and predicting clinical outcome in cirrhotic outpatients[J]. Nutrition200521(2):113-117.
12
Lan CC Su WL Yang MC,et al. Predictive role of neutrophil-percentage-to-albumin,neutrophil-to-lymphocyte and eosinophil-to-lymphocyte ratios for mortality in patients with COPD:evidence from NHANES 2011-2018[J]. Respirology202328(12):1136-1146.
13
status Physical :the use and interpretation of anthropometry. Report of a WHO Expert Committee[J]. World Health Organ Tech Rep Ser1995854:1-452.
14
Johnson CL Dohrmann SM Burt VL,et al. National health and nutrition examination survey:sample design,2011-2014[J]. Vital Health Stat 22014(162):1-33.
15
Chai XM Chen YJ Li YL,et al. Lower geriatric nutritional risk index is associated with a higher risk of all-cause mortality in patients with chronic obstructive pulmonary disease:a cohort study from the National Health and Nutrition Examination Survey 2013-2018[J]. BMJ Open Respir Res202310(1):e001518.
16
Kaluźniak-Szymanowska A Krzymińska-Siemaszko R Wieczo-rowska-Tobis K,et al. Optimal assessment of nutritional status in older subjects with the chronic obstructive pulmonary disease-a comparison of three screening tools used in the GLIM diagnostic algorithm[J]. Int J Environ Res Public Health202219(3):1025.
17
Zhang X Wang Y Cheng Z,et al. The malnutrition in AECOPD and its association with unfavorable outcomes by comparing PNI,GNRI with the GLIM Criteria:a retrospective cohort study[J]. 202320(4):1125-1210.
18
Kaluźniak-Szymanowska A Krzymińska-Siemaszko R Deskur-Śmielecka E,et al. Malnutrition,sarcopenia,and malnutrition-sarcopenia syndrome in older adults with COPD[J]. Nutrients202114(1):44.
19
Dalle S Koppo K. Is inflammatory signaling involved in disease-related muscle wasting?Evidence from osteoarthritis,chronic obstructive pulmonary disease and type Ⅱdiabetes[J]. Exp Gerontol2020137:110964.
20
Correia MITD Sulo S Brunton C,et al. Prevalence of malnutrition risk and its association with mortality:nutritionDay Latin America survey results[J]. Clin Nutr202140(9):5114-5121.
21
Soeters PB Wolfe RR Shenkin A. Hypoalbuminemia:pathogenesis and clinical significance[J]. JPEN J Parenter Enteral Nutr201943(2):181-193.
22
Ma L Li HY Chen SL,et al. Relationship between human serum albumin and in-hospital mortality in critical care patients with chronic obstructive pulmonary disease[J]. Front Med202310:1109910.
23
Jin XR Xiong SZ Ju SY,et al. Serum 25-hydroxyvitamin D,albumin,and mortality among Chinese older adults:a population-based longitudinal study[J]. J Clin Endocrinol Metab2020105(8):dgaa349.
24
Chapman NM Chi HB. Metabolic adaptation of lymphocytes in immunity and disease[J]. Immunity202255(1):14-30.
25
Shirai Y Momosaki R Kokura Y,et al. Validation of Asian body mass index cutoff values for the classification of malnutrition severity according to the global leadership initiative on malnutrition criteria in patients with chronic obstructive pulmonary disease exacerbations[J]. Nutrients202214(22):4746.
26
Kahnert K Jörres RA Behr J,et al. The diagnosis and treatment of COPD and its comorbidities[J]. Dtsch Arztebl Int2023120(25):434-444.
27
Machado FVC Spruit MA Groenen MTJ,et al. Frequency and functional translation of low muscle mass in overweight and obese patients with COPD[J]. Respir Res202122(1):93.
28
World Health Organization. The double burden of malnutrition:policy brief[R]. World Health Organization,2016.

Comments

PDF(829 KB)

Accesses

Citation

Detail

Sections
Recommended

/