PP449 - EARLY ORAL INTAKE IS ASSOCIATED WITH REDUCED RISK OF HOSPITAL-ASSOCIATED DISABILITY IN PATIENTS WITH COPD: A NATIONWIDE COHORT STUDY

PP449

EARLY ORAL INTAKE IS ASSOCIATED WITH REDUCED RISK OF HOSPITAL-ASSOCIATED DISABILITY IN PATIENTS WITH COPD: A NATIONWIDE COHORT STUDY

A. Nagano^1,*, K. Maeda², T. Inoue³

¹Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Hyogo, ²Nutrition Therapy Support Center, Aichi Medical University Hospital , Aichi, ³Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan

Rationale: Hospital-associated disability (HAD), defined as functional decline during hospitalization, is associated with poor outcomes. The impact of oral intake timing remains unclear. The aim of this study was to investigate the association between the timing of oral intake initiation and the development of HAD in patients with COPD.

Methods: This retrospective study used a nationwide administrative database in Japan. HAD was defined as a ≥5-point decline in the Barthel Index. Patients with a baseline Barthel Index of 0 were excluded from the primary analysis because they were not at risk for HAD. Patients were categorized into very early (1–2 days), early (3–4 days), and late (≥5 days) groups. Multivariable logistic regression was performed with adjustment for rehabilitation intervention. Trend analysis and inverse probability of treatment weighting (IPTW) were conducted.

Results: A total of 19,806 patients were included in the primary analysis. Delayed initiation of oral intake was significantly associated with an increased risk of HAD. Compared with the very early group, both early (OR 1.60, 95% CI 1.19–2.11) and late initiation (OR 3.08, 95% CI 2.03–4.56) were independently associated with HAD. A significant dose–response relationship was observed (OR 1.36 per category delay, 95% CI 1.15–1.60). These associations remained unchanged after adjustment for rehabilitation intervention, which was not independently associated with HAD. IPTW analysis yielded consistent results (early: OR 1.83, 95% CI 1.35–2.48; late: OR 3.33, 95% CI 2.13–5.19), with good covariate balance.

Conclusion: Delayed initiation of oral intake is independently associated with an increased risk of HAD in patients with COPD in a dose-dependent manner. Early oral intake initiation may be a key modifiable factor for preventing functional decline during hospitalization.

Disclosure of Interest: None declared