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The influence of deprivation on malnutrition risk in outpatients with chronic obstructive pulmonary disease (COPD)

The influence of deprivation on malnutrition risk in outpatients with chronic obstructive pulmonary disease (COPD)
The influence of deprivation on malnutrition risk in outpatients with chronic obstructive pulmonary disease (COPD)

Background & aims: The social gradient in chronic obstructive pulmonary disease (COPD) is considerable, but the influence of deprivation on common clinical risk factors such as malnutrition is unclear. This study aimed to explore the relationship between COPD disease-severity, deprivation and malnutrition.

Methods: 424 outpatients with a confirmed diagnosis of COPD were routinely screened for malnutrition risk using the ‘Malnutrition Universal Screening Tool’ (‘MUST’) while attending respiratory clinics across two hospitals; a large city hospital (site A) and a smaller community hospital (site B). Deprivation was assessed for each outpatient according to their address (postcode) using the English governments' index of multiple deprivation (IMD) and related to malnutrition risk. Each postcode was attributed to both an IMD score and IMD rank, where a higher IMD score and a lower IMD ranking indicated increased deprivation.

Results: Overall prevalence of malnutrition was 22% (95% CI 18–26%; 9% medium risk, 13% high risk). It was significantly higher at site A (28% vs 17%; p = 0.004) where patients were also significantly more likely to reside in areas of more deprivation than those at site B (IMD rank: 15,510 SD 8137 vs 22,877 SD 6827; p < 0.001). COPD disease-severity was positively associated with malnutrition (p < 0.001) whilst a higher rank IMD was negatively associated with malnutrition (p = 0.014).

Conclusions: Deprivation is a significant independent risk factor for malnutrition in outpatients with COPD. Consideration of deprivation is important in the identification of malnutrition and the nutritional management of patients with COPD.

0261-5614
144–148
Collins, Peter
580e9a16-a6e4-4466-8a36-6db713f716c4
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1
Kurukulaaratchy, Ramesh
9c7b8105-2892-49f2-8775-54d4961e3e74
Stratton, Rebecca
c6a5ead1-3387-42e7-8bea-5ac7d969d87b
Collins, Peter
580e9a16-a6e4-4466-8a36-6db713f716c4
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1
Kurukulaaratchy, Ramesh
9c7b8105-2892-49f2-8775-54d4961e3e74
Stratton, Rebecca
c6a5ead1-3387-42e7-8bea-5ac7d969d87b

Collins, Peter, Elia, Marinos, Kurukulaaratchy, Ramesh and Stratton, Rebecca (2018) The influence of deprivation on malnutrition risk in outpatients with chronic obstructive pulmonary disease (COPD). Clinical Nutrition, 37 (1), 144–148. (doi:10.1016/j.clnu.2016.11.005). (PMID:27866758)

Record type: Article

Abstract

Background & aims: The social gradient in chronic obstructive pulmonary disease (COPD) is considerable, but the influence of deprivation on common clinical risk factors such as malnutrition is unclear. This study aimed to explore the relationship between COPD disease-severity, deprivation and malnutrition.

Methods: 424 outpatients with a confirmed diagnosis of COPD were routinely screened for malnutrition risk using the ‘Malnutrition Universal Screening Tool’ (‘MUST’) while attending respiratory clinics across two hospitals; a large city hospital (site A) and a smaller community hospital (site B). Deprivation was assessed for each outpatient according to their address (postcode) using the English governments' index of multiple deprivation (IMD) and related to malnutrition risk. Each postcode was attributed to both an IMD score and IMD rank, where a higher IMD score and a lower IMD ranking indicated increased deprivation.

Results: Overall prevalence of malnutrition was 22% (95% CI 18–26%; 9% medium risk, 13% high risk). It was significantly higher at site A (28% vs 17%; p = 0.004) where patients were also significantly more likely to reside in areas of more deprivation than those at site B (IMD rank: 15,510 SD 8137 vs 22,877 SD 6827; p < 0.001). COPD disease-severity was positively associated with malnutrition (p < 0.001) whilst a higher rank IMD was negatively associated with malnutrition (p = 0.014).

Conclusions: Deprivation is a significant independent risk factor for malnutrition in outpatients with COPD. Consideration of deprivation is important in the identification of malnutrition and the nutritional management of patients with COPD.

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Accepted/In Press date: 1 November 2016
e-pub ahead of print date: 11 November 2016
Published date: February 2018
Organisations: NIHR Southampton Respiratory Biomedical Research Unit

Identifiers

Local EPrints ID: 405751
URI: https://eprints.soton.ac.uk/id/eprint/405751
ISSN: 0261-5614
PURE UUID: b535b937-73e0-41a0-a1d1-219a0290c573

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Date deposited: 18 Feb 2017 00:21
Last modified: 14 Aug 2019 17:44

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Contributors

Author: Peter Collins
Author: Marinos Elia
Author: Ramesh Kurukulaaratchy
Author: Rebecca Stratton

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