Effectiveness of individualized nutritional support in improving clinical symptoms of patients with acute exacerbations of chronic obstructive pulmonary disease: a pre-post intervention study.

BACKGROUND

Malnutrition, a significant complication, triggers devastating consequences among patients with chronic obstructive pulmonary disease (COPD). Although previous studies have demonstrated the benefits of nutritional support in stable COPD, evidence in hospitalized patients with acute exacerbations remains limited. This study aimed to examine the short-term association between individualized nutritional support and changes in nutritional status and clinical symptoms among inpatients with acute COPD exacerbations.

METHODS

Thirty male inpatients diagnosed with acute exacerbations of COPD were enrolled in a 40-day individualized nutritional intervention program. The intervention included tailored dietary counseling based on each patient's energy and protein requirements, alongside hospital-standard medical treatment. Anthropometric measurements, serum albumin levels, and Subjective Global Assessment (SGA) were assessed at the hospital admission (T0), 7 days (T7), and 40 days (T40) of intervention. Clinical symptoms, including fatigue, dyspnea, anorexia, dysphagia, and bloating, were also monitored. Statistical analyses were two-sided, and significance was set at P<0.05.

RESULTS

Thirty COPD patients (mean age 68.4±8.6 years; 66.7% aged >65 years) completed the 40-day individualized nutritional intervention. At baseline, 70% had chronic energy deficiency (CED) and 83.3% were malnourished (SGA-B/C). After intervention, the proportion of well-nourished patients (SGA-A) increased from 16.7% to 80%. Serum albumin rose significantly from 36.4±0.7 to 38.3±0.7 g/L (P=0.005). Mean BMI increased from 17.7±2.2 to 18.1±2.3 kg/m2, and CED prevalence declined from 70% to 53.3%. Fatigue, dyspnea, and anorexia markedly improved following intervention.

CONCLUSIONS

Individualized nutritional support was associated with notable improvements in nutritional status and clinical symptoms among patients hospitalized with acute exacerbations of COPD. These findings underscore the value of incorporating tailored nutritional care into routine COPD management. However, given the small, male-only sample and short follow-up duration, further large-scale and long-term studies are warranted to verify the durability and broader applicability of these outcomes.