Supplemental Material for:Sustained but Attenuated Weight Gain following Pulmonary Rehabilitation in COPD: Evidence for a Gap in Post-Discharge Nutritional Care

A multicenter study was conducted combining retrospective analysis with prospective follow-up. Patients with COPD stages 2–4 undergoing inpatient PR were included. Patients with BMI ≥25 kg/m² and incomplete PR were excluded.

Body weight was assessed on admission, discharge, and follow-up. Secondary outcomes: 6-minute walk test (6MWT), nutritional care variables following discharge. Linear mixed models were used to analyze weight trajectories.

Results: 75 patients were included. Body weight increased during PR and remained higher at follow-up (57.7 kg on admission, 59.5 kg at discharge, and 60.6 kg at follow-up; p<0.001). Patients receiving ONS had lower baseline BMI, without a differential effect on weight trajectories.

Nutritional counselling declined following discharge (21% at follow-up). In a logistic regression analysis, lower BMI at discharge was associated with a higher likelihood of post-discharge nutritional counselling (OR 0.72 per kg/m² increase, 95% CI 0.57–0.91, p=0.007). Conclusion: PR was associated with an increase in body weight that persisted after discharge, although the magnitude of weight gain attenuated over time.

The marked decline in post-discharge nutritional counselling highlights a potential gap in continuity of nutritional care. Future studies should evaluate whether structured long-term nutritional follow-up can improve nutritional outcomes after PR.</p>