Mini-Nutritional Assessment Questionnaire for Assessing the Nutritional Status of Patients with Chronic Obstructive Pulmonary Disease: A Cross-sectionalStudy

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that in most cases has systemic effects like malnutrition that increase morbidity and mortality. Nutritional assessment in COPD is underutilized in Nepal even though the assessment is clinically relevant.
Methods: The study involved 140 stable COPD patients, who were studied at the Department of Pulmonology, Institute of Medicine, Tribhuvan University using the cross-sectional study design. Mini Nutritional Assessment (MNA) was used to determine the nutritional status. Demographic variables, anthropometric and spirometry parameters and clinical variables were taken. The associations were compared based on chi-square, one-way ANOVA, and Pearson correlation whereby p < 0.05 was regarded as significant.
Results: Mean age and BMI were 60.6 ± 9.5years and 21.3±3.5 kg/m 2, respectively; 61.4% were males, and 70.7% were rural inhabitants. MNA indicated that 70.0 % were at risk of malnutrition, 12.1% were malnourished and 17.9% of the population was well nourished. GOLD stage (p = 0.034) and BMI (p < 0.001) however had a significant relationship with nutrition status with non-significant relationship between spirometry indices and dyspnea grade. There was a moderately positive association between MNA and BMI (r = 0.501, p < 0.001), but no significant association between MNA and FEV 1 and mMRC. These results indicate that nutritional impairment is more associated with anthropometric than pulmonary parameters.
Conclusions: In Nepal, COPD patients have high prevalence of malnutrition and the severity increases with the disease conditions. COPD management should include routine screening of MNA and early nutritional interventions in order to enhance clinical outcomes.