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

• Main Authors: Zichen Ji, Javier de Miguel-Díez, Christian Reynaldo Castro-Riera, José María Bellón-Cano, Virginia Gallo-González, Walther Iván Girón-Matute, Rodrigo Jiménez-García, Ana López-de Andrés, Virginia Moya-Álvarez, Luis Puente-Maestu, Julio Hernández-Vázquez
• Format: Article
• Language: English
• Published: MDPI AG 2020-03-01
• Series: Journal of Clinical Medicine
• Subjects: chronic obstructive pulmonary disease (copd); body mass index; survival; risk factor
• Online Access: https://www.mdpi.com/2077-0383/9/3/710

Background: In chronic obstructive pulmonary disease (COPD), the &#8220;obesity paradox&#8221; is a phenomenon without a clear cause. The objective is to analyze the complications of COPD patients according to their body mass index (BMI). Methods: 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. Results: A total of 273 patients were included. BMI quartiles were &#8804;24.23; 24.24&#8722;27.69; 27.70&#8722;31.25; &#8805;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&#8722;4 quartiles (<i>p</i>-value 0.019, 0.013, and 0.004, respectively). Advanced age (hazard ratio, HR 1.06; 95% confidence interval, CI 1.03&#8722;1.09), low pulmonary function (HR 0.93; 95% CI 0.86&#8722;0.99), exacerbator with chronic bronchitis phenotype (HR 1.76; 95% CI 1.01&#8722;3.06), high Charlson (HR 1.32, 95% CI 1.18&#8722;1.49), and the quartile 1 of BMI (HR 1.99, 95% CI 1.08&#8722;3.69) were identified as risk factors independently associated with mortality. Conclusions: In COPD, low BMI conditions a lower survival, although not for having more acute events.