The effect of malnutrition on exacerbation inpatients diagnosed with NON-cystic fibrosisbronchiectasis

Non-cystic fibrosis bronchiectasis (NCFB) is characterized by persistent abnormal bronchial enlargements accompanied by chronic cough, sputum, and bronchial infection symptoms. In NCFB, malnutrition may develop as a result of insufficient nutrient intake, an increased need for protein/energy due to inflammation, which may increase the frequency of exacerbations. Our study aims to examine the impact of malnutrition on exacerbations in patients with NCFB. 86 patients with ICD-10 code J47 who visited the BUU Chest Diseases outpatient clinic between January 1, 2020 and August 31, 2021 were included. Patients' demographics, symptoms, PFT parameters, BMI, Charlson and BACI comorbidity indices, BSI, HADS, fatigue severity scores, bioimpedance analysis and anthropometric measurements, Thorax CT L1 section skeletal muscle area were all determined. The NRS-2002 score, as well as the relationships between annual exacerbations and hospitalizations were examined. In our study, when the cases were examined based on their NRS-2002≥3; a statistically significant decrease in BMI, BSI, lymphocyte and hemoglobin values, FFMI, upper arm circumference, calf circumference, SMI values, and an increase in CRP, in the previous year's hospitalization frequency were found. A decrease in FEV1, FVC, hemoglobin levels, and paraspinal muscle area; an increase in platelet count, presence of sputum symptoms, hospital anxiety score and BSI value were statistically significant. In cases when patients' exacerbation status is ≥2, a statistically significant decrease in FEV1,FVC and in dominant hand grip test from anthropometric measurements; an increase in the presence of cough, sputum, and in the BSI value was detected. In logistic regression analysis, each unit increase in BSI score increased the chance of having 2 or more exacerbations in the previous year by 1.04 times; the risk of having 3 or more exacerbations increased by 1.05 times. Each unit increase in the dominant hand grip test reduces the risk of two or more exacerbations in the previous year by 2%; the presence of male gender reduced the risk of malnutrition by 19%, 1 unit increase in FFMI reduced the risk of malnutrition by 6%, and a unit increase in CRP value increased the risk of malnutrition 1.01 times. Based on our findings, we believe that simple and reproducible tests that we can use in our daily practice to manage NCFB will help us predict the risk of exacerbation and malnutrition. Keywords: exacerbation, malnutrition, bronchiectasis