The Effect of Nutritional Status on Walking Ability at Discharge in Patients with Acute Exacerbations of COPD

• Published in: Physical Therapy Japan Vol. 47; no. 2; pp. 166 - 173
• Main Authors: NAKADA, Shuichi, WATANABE, Yosuke, KOMASE, Yuko, MINESHITA, Masamichi, AIKAWA, Shun, MATSUSHIMA, Shinya, NAKAKUKI, Atsushi, TAKEICHI, Rie, KOBAYASHI, Takayuki, YOKOYAMA, Hitoshi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Physical Therapy 2020; 日本理学療法士学会
• Subjects: Acute exacerbation of COPD; COPD 急性増悪; Nutritional status; Walking ability; 栄養; 歩行自立度
• ISSN: 0289-3770; 2189-602X
• DOI: 10.15063/rigaku.11668

Purpose: This retrospective study aimed to clarify the associations between nutritional status and walking ability at discharge in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods: We enrolled 101 patients hospitalized for AECOPD and who underwent physical therapy. Walking ability was assessed by Functional Independence Measure (FIM). The subjects were classified into the independent group (FIM ≥6) and non-independent group (FIM <6) by walking ability at discharge. The presence of malnutrition (% ideal body weight <80%) and adequacy of caloric intake (% estimated target calories: intake/estimated target calories × 100) were examined as indices of nutritional status. Multivariate logistic regression analysis was performed to assess whether nutritional status affected walking ability at discharge (FIM ≥6 or FIM <6) adjusted by age, A-DROP, and severity of airflow obstruction.Results: Despite being independent before hospitalization, 21 patients could not walk independently at discharge, and 31 patients had malnutrition before admission. The average % estimated target calories was 78.7 ± 31.7%. Multiple logistic regression analysis showed presence of malnutrition (OR 3.9, 95% CI 1.3–11.7, p<0.05) and % estimated target calories (OR 0.7, 95% CI 0.5–0.9, p<0.05) to be significantly associated with walking ability at discharge.Conclusion: Nutritional status affected walking ability of AECOPD patients at discharge. Therefore, nutritional status should be evaluated when providing effective exercise and adequate nutritional therapy during hospitalization. These findings may imply that oral nutritional supplements should be provided immediately after hospitalization for patients with inadequate caloric intake.