SOURCE: Snider JT, et al. Effect of hospital use of oral nutritional supplementation on length of stay, hospital cost, and 30-day readmissions among Medicare patients with COPD. Chest 2015;147:1477-1484.
In contrast to many of the other top 10 causes of death in the United States, chronic obstructive pulmonary disease (COPD) deaths are increasing, such that COPD is now the third most common cause of death. Although a variety of pharmacologic interventions are available to improve symptoms and decrease exacerbations, none has been shown to reduce mortality.
COPD is associated with increased risk for malnutrition, which may lead to further respiratory function compromise and immune dysfunction. Might nutritional supplementation of patients admitted for COPD improve outcomes?
Snider et al utilized the Premier Research Database, which contains hospitalization information from 460 U.S. hospitals and 46 million hospitalizations. The authors compared outcomes in persons > 65 years of age admitted for COPD (n = 378,419) who received oral nutritional supplementation (n = 10,322) vs those who did not. Outcomes of interest were length of hospital stay, hospitalization costs, and readmission rates.
Oral nutritional supplementation was announced with numerous favorable results: Length of stay was reduced by 21.5%, readmission rate was reduced by 7%, and even the cost of hospitalization was reduced by 12.5%. Overall, the results suggested that for every dollar spent on oral nutritional supplementation, the hospital saved $18.
It is clear oral nutritional supplementation has been employed in a small minority of COPD admissions (10,322 out of 378,419 admissions). These favorable results should prompt reconsideration of the value — health wise and economic — of oral nutritional supplementation in patients admitted for COPD.