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| Assessment of body composition and sarcopenia in the prognosis of patients with chronic obstructive pulmonary disease |
| Gu Jiawei, Zhu Xiangyang, Ji Hongyan, Xu Yan |
| Department of Respiratory Medicine Nantong Cancer Hospital Nantong 226006 Jiangsu China |
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Abstract Objective To evaluate the prognostic value of body composition and sarcopenia in patients with chronic obstructive
pulmonary disease COPD . Method A total of 185 COPD patients admitted to Nantong Cancer Hospital from June 2021 to June 2022
were included. The patients were followed up for 1 year and their survival was recorded. All patients' clinical information baseline data
were measured and recorded at admission. General information included age sex BMI hypertension and diabetes. Body composition
indicators include waist circumference phase angle midarm circumference calf circumference. Result A total of 185 patients
observed 16 died representing a mortality rate of 8. 6%. According to whether the patients died or not the results showed that The
age and incidence of sarcopenia in death group were significantly higher than those in survival group while the phase angle was
significantly lower in death group compared to the survival group with statistically significant differences P<0. 05 . Cox proportional
model results showed that age reduction was significantly associated with a lower risk of death in COPD patients HR= 0. 832 95%CI =
0. 706-0. 982 P= 0. 030 . Sarcopenia was significantly associated with an increased risk of death in COPD patients HR = 3. 377
95% CI = 1. 126- 10. 1330 P = 0. 030 . Decreased phase Angle was significantly associated with increased risk of death in COPD
patients HR= 2. 746 95% CI = 1. 165-6. 472 P= 0. 021 . ROC curve results showed that the AUC of age predicting the prognosis of
COPD was 0. 814 the maximum Youden index was 0. 546 the corresponding sensitivity was 88. 2% and the specificity was 66. 4%.
Sarcopenia predicted the outcome of COPD with an AUC of 0. 780 a maximum Youden index of 0. 417 a corresponding sensitivity of 64. 7%
and a specificity of 77. 0%. The phase angle predicted the prognosis of COPD with an AUC of 0. 850 a maximum Youden index of 0. 612 a
corresponding sensitivity of 88. 2% and a specificity of 73. 0%. Conclusion Both decreased phase angle and sarcopenia were significantly
associated with an increased risk of death in COPD patients. Decreased phase angle and sarcopenia have high prognostic value in COPD
patients. However due to the relatively small sample size in this study the model's stability is suboptimal.
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