Screening method evaluated by nutritional status measurements can be used to detect malnourishment in chronic obstructive pulmonary disease

Objective To evaluate and develop a screening method for malnutrition among patients with chronic obstructive pulmonary disease (COPD). Design Findings from a screening sheet for malnutrition were compared with results from full nutritional assessment. The screening sheet included 7 qu estions regarding body mass index, anorexia, toss of weight, and other vari ables possibly affecting nutritional status. Each answer was assigned a poi nt value, and a total of 4 and 5 points were tested as criterion for malnut rition. Full nutrition assessment included measurements of weight and heigh t (body mass index, serum albumin and prealbumin, total lymphocyte count, t riceps skinfold thickness, mid-arm muscle circumference or area, and inform ation on unintentional weight loss. Malnutrition was defined by 3 or more v alues below reference values. Subjects Randomly selected patients (n=34) with a clinical diagnosis of COP D, 15% of eligible patients admitted to the Department of Lung Medicine at National University Hospital, Reykjavik, Iceland, during the time of the st udy. Statistical analysis Sensitivity, specificity, and predictive values were c alculated to evaluate the screening sheet. Each of the 7 parameters used in a full nutrition assessment was similarly evaluated as an indicator to pre dict malnutrition. Results Full nutrition assessment identified 13 of 34 patients (38%) as mal nourished. Using 4 points as a criterion for malnutrition, the screening sh eet to be used for patients with COPD resulted in sensitivity of 0.69 and s pecificity of 0.90. Conclusion The results confirm the frequent finding of malnutrition among p atients with COPD and show that a simple screening sheet can be used to ide ntify which patients need further nutrition assessment and treatment.