Differences in the Outcome of Patients with COPD according to Body Mass Index

• Published in: Journal of clinical medicine Vol. 9; no. 3; p. 710
• Main Authors: Ji, Zichen, de Miguel-Díez, Javier, Castro-Riera, Christian Reynaldo, Bellón-Cano, José María, Gallo-González, Virginia, Girón-Matute, Walther Iván, Jiménez-García, Rodrigo, López-de Andrés, Ana, Moya-Álvarez, Virginia, Puente-Maestu, Luis, Hernández-Vázquez, Julio
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 05.03.2020; MDPI
• Subjects: Body mass index; Bronchitis; Chronic obstructive pulmonary disease; Clinical medicine; Comorbidity; Emphysema; Genotype & phenotype; Hospitals; Medical prognosis; Multivariate analysis; Obesity; Patients; Pneumonia; Respiratory therapy; Sleep apnea; risk factor; body mass index; chronic obstructive pulmonary disease (COPD); survival
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm9030710

In chronic obstructive pulmonary disease (COPD), the "obesity paradox" is a phenomenon without a clear cause. The objective is to analyze the complications of COPD patients according to their body mass index (BMI). An observational study with a six-year prospective follow-up of 273 COPD patients who attended a spirometry test in 2011. Survival and acute events were analyzed according to the BMI quartiles. A total of 273 patients were included. BMI quartiles were ≤24.23; 24.24-27.69; 27.70-31.25; ≥31.26. During the follow-up, 93 patients died. No differences were found in exacerbations, pneumonia, emergency visits, hospital admissions or income in a critical unit . Survival was lower in the quartile 1 of BMI with respect to each of the 2-4 quartiles ( -value 0.019, 0.013, and 0.004, respectively). Advanced age (hazard ratio, HR 1.06; 95% confidence interval, CI 1.03-1.09), low pulmonary function (HR 0.93; 95% CI 0.86-0.99), exacerbator with chronic bronchitis phenotype (HR 1.76; 95% CI 1.01-3.06), high Charlson (HR 1.32, 95% CI 1.18-1.49), and the quartile 1 of BMI (HR 1.99, 95% CI 1.08-3.69) were identified as risk factors independently associated with mortality. In COPD, low BMI conditions a lower survival, although not for having more acute events.