NUTRITIONAL-STATUS AND MORTALITY IN CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

The role of nutritional status in the prognosis of subjects with sever e chronic obstructive pulmonary disease was studied in a cohort of Can adian men and women followed for 3 to 5 yr. A total of 348 subjects wh o were recruited for a study of negative pressure ventilation were eva luated for lung function and body weight, and a subset who entered hos pital for the study (n = 184) had baseline measures of diffusing capac ity, maximal inspiratory and expiratory mouth pressures (PImax and PE( max)), and blood gases. Predictors of survival were analyzed using Cox regression models. In the total cohort, low body mass index (BMI) and use of home oxygen were independently associated with reduced surviva l. In the hospitalized group, predictors of respiratory mortality were elevated Pa-CO2 and low BMI, PImax, and diffusing capacity. Pa-O2 (me asured on oxygen therapy), FEV(1), PE(max), age, smoking behavior, and gender were not associated with survival. The predictors of total mor tality were similar, except that BMI was no longer significant. In con clusion, low body weight, a potentially modifiable factor, was associa ted with respiratory mortality, but whether it has a casual effect or is a marker of declining health can only be resolved through an interv ention trial.