Does Nutritional Risk Screening 2002 Correlate with the Dyspnea Status of Patients with GOLD Stage C-D Chronic Obstructive Pulmonary Disease?

Nalan Ogan; Fatma Yıldırım; Banu Süzen; Ayşe Baha; Evrim Eylem Akpınar

doi:10.5152/TurkThoracJ.2019.180194

Does Nutritional Risk Screening 2002 Correlate with the Dyspnea Status of Patients with GOLD Stage C-D Chronic Obstructive Pulmonary Disease?

Turk Thorac J. 2020 Jan;21(1):49-53. doi: 10.5152/TurkThoracJ.2019.180194. Epub 2020 Jan 1.

Authors

Nalan Ogan¹, Fatma Yıldırım², Banu Süzen³, Ayşe Baha⁴, Evrim Eylem Akpınar¹

Affiliations

¹ Department of Pulmonary Medicine, Ufuk University School of Medicine, Ankara, Turkey.
² Clinic of Pulmonary and Critical Care Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
³ Department of Nutrition and Dietician, Ufuk University School of Medicine, Ankara, Turkey.
⁴ Clinic of Chest Diseases, Kyrenia State Hospital, Kyrenia, Cyprus.

Abstract

Objectives: Dyspnea is a prominent symptom of chronic obstructive pulmonary disease (COPD). Patients with Global Initiative for Obstructive Lung Disease (GOLD) Stage C-D often complain of dyspnea, but the relationship between their level of dyspnea and their nutritional status has not yet been established. The aim of this study was to evaluate the dyspnea levels and nutritional status ofstable COPD patients in the out patient clinic.

Materials and methods: Medical records including the Modified Medical Research Council (mMRC) Dyspnea Scale and the nutritional status of 41 patients were investigated in the study. The meanage of patients was 71.7±9.2 years. The Nutritional Risk Screening 2002 (NRS-2002) tool, body mass index (BMI), and mid-upper arm circumference were used to evaluate their nutritional status. We used correlation analysis to display the relationship between NRS-2002 score and MRC, COPD stage, and biochemical and anthropometric parameters indicating the nutritional status of patients.

Results: Out of the 41 COPD patients 87.8% (36) enrolled in the study were men and 12.2% (5) were women. The GOLD stages of the patients were 29.3% of patients with stage C and 70.7% with stage D. The risk of malnutrition (NRS ≥3) was detected in 48.8% of the patients, whereas 51.2% of patients (NRS<3) were risk-free. The mid-upper arm circumference of at risk patients was lower (25.6±3.2 vs 29.9±2.7 cm, p=0.032). The NRS-2002 score had a positive correlation with mMRC records (r=0.351, p=0.024). There was a statistically significant negative correlation between the NRS-2002 score and the mid-upper arm circumference (r=0.604, p<0.0001). Also, there was a negative correlation between BMI and mid-upper arm circumference (r=0.699, p<0.0001).

Conclusion: The risk of malnutrition was common in stable COPD patients at the outpatient clinic, which seemed to adversely affect their dyspnea level. Therefore, while planning the treatment of COPD patients, evaluating their nutritional status and taking precautions accordingly contribute to the shortness of breath which is one of the most significant symptoms of the disease.