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 questions regarding body mass index, anorexia, toss of weight, and other variables possibly affecting nutritional status. Each answer was assigned a point value, and a total of 4 and 5 points were tested as criterion for malnutrition. Full nutrition assessment included measurements of weight and height (body mass index, serum albumin and prealbumin, total lymphocyte count, triceps skinfold thickness, mid-arm muscle circumference or area, and information on unintentional weight loss. Malnutrition was defined by 3 or more values below reference values. Subjects Randomly selected patients (n=34) with a clinical diagnosis of COPD, 15% of eligible patients admitted to the Department of Lung Medicine at National University Hospital, Reykjavik, Iceland, during the time of the study. Statistical analysis Sensitivity, specificity, and predictive values were calculated to evaluate the screening sheet. Each of the 7 parameters used in a full nutrition assessment was similarly evaluated as an indicator to predict malnutrition. Results Full nutrition assessment identified 13 of 34 patients (38%) as malnourished. Using 4 points as a criterion for malnutrition, the screening sheet to be used for patients with COPD resulted in sensitivity of 0.69 and specificity of 0.90. Conclusion The results confirm the frequent finding of malnutrition among patients with COPD and show that a simple screening sheet can be used to identify which patients need further nutrition assessment and treatment.