The Relationship Between Mortality, Nutritional Status, and Laboratory Parameters in Geriatric Chronic Obstructive Pulmonary Disease Patients

Background: In geriatric patients, limitations in physical, mental, and/or social functions occur as a result of acute and/or chronic disease along with age-related degenerative changes. This study aimed to investigate the relationship between nutritional status, mean platelet volume (MPV), C-reactive protein (CRP)-to-albumin ratio (CAR), and mortality in geriatric chronic obstructive pulmonary disease (COPD) patients.

Methods: Patients aged 65 years and older who were tertiary state hospitalized with COPD were included in the study. Demographic data of the patients, diagnosis, nutritional risk score-2002 (NRS-2002) score, and body mass index (BMI) were recorded. Glucose, MPV, CRP, albumin, CAR values of the patients, as well as 30-day and 90-day mortality status after nutritional evaluation, were determined. Patients hospitalized for a reason other than COPD, those using anti-inflammatory drugs, patients with missing data, and those in intensive care units were excluded from the study. Patients were divided into two groups based on NRS-2002: NRS-2002; 1 and 2, and NRS-2002; ≥3.

Results: Four hundred eighteen patients were hospitalized for COPD. Of these patients, 279 were aged 65 and over, but due to missing data, only 261 patients' data were analyzed. The 30-day and 90-day mortality rates were quite high in patients with a diagnosis of COPD who needed nutritional support (37.5% and 49.8%). When the demographic data and laboratory values of the patients are examined according to the 30-day and 90-day mortality status, the MPV value is statistically significantly higher in those with mortality at the end of 90 days (p < 0.05). Despite the fact that the NRS-2002 ≥3 group had higher 30-day and 90-day mortality rates than the NRS-2002 1 or 2 groups, there was no statistically significant difference between the groups (p > 0.05).

Conclusions: As a result, 90-day mortality was observed in approximately half of the patients, and the majority of these patients were male. Parameters that could predict 30-day and 90-day mortality could not be determined without MPV. Inflammatory parameters such as MPV can guide the determination of nutritional needs, especially in geriatric patients with COPD. Because of the high mortality rates in geriatric patients with COPD who need nutritional support, nutritional support should be started without delay in these patients. There is a need for prospective randomized controlled multicenter studies on this subject.