Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease

Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary
disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and
requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either
energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March
2015–March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1–5 d after
admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake
≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than
lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein
intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of
follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study
population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after
discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.