Association Between Anthropometric Indicators of Nutrition Status and Length of Hospital Stay in Hospitalized Patients

Abstract

Background Undernutrition is associated with increased hospital length of stay (LOS). Anthropometrics is required for undernutrition screening and diagnosis. However, the measurements which are more strongly associated with LOS are to be specified. This study aims to measure the independent association of weight, triceps skinfold thickness (TST), mid‐upper arm circumference (MUAC), adductor pollicis muscle thickness (APMT), mid‐upper arm muscle area (AMA), mid‐upper arm muscle circumference (AMC), and body mass index (BMI) with LOS and investigating whether these indicators had similar validity in predicting LOS. Methods Six hundred ninety‐five patients participated in a prospective observational study. Participants were dichotomized indicators studied according to the 5th and 25th percentiles described in the literature (for APMT only the 5th percentile was used). Cox regression analysis was used to estimate adjusted hazard ratios (HRs) and corresponding 95% CIs. Results Patients that presented values <5th percentile for TST (HR, 0.759; 95% CI, 0.579–0.995), MUAC (HR, 0.822; 95% CI, 0.687–0.983), APMT (HR, 0.791; 95% CI, 0.671–0.933), AMA (HR, 0.797, 95% CI, 0.660–0.962), and AMC (HR, 0.746; 95% CI, 0.611–0.911) showed a lower probability of being discharged to usual residence. Patients whose TST values were <25th percentile also presented lower probability of being discharged to usual residence (HR, 0.798; 95% CI, 0.673–0.946). No associations were found between weight and BMI with LOS. Conclusion Depletion of TST, MUAC, APMT, AMA, and AMC was associated with lower probability of being discharged to usual residence. A thicker TST was independently associated with this outcome and thus TST should be considered for undernutrition screening and diagnosis.

Low‐cost and fast‐performing indicators of muscle mass loss are good predictors of clinical outcomes in hospitalized patients: A longitudinal observational study

“…Furthermore, results from a large sample of hospitalized patients showed that low APMT values (less than the fifth percentile) were associated with a lower probability of being discharged to their usual residence in ∼20% of patients. However, the frequency of low APMT was higher than that in our study (40% vs 13%, respectively) 44 …”

“…However, the frequency of low APMT was higher than that in our study (40% vs 13%, respectively). 44 For APMT measurement, it is necessary that patients do not have edema or atrophy in their hands. Therefore, it can be applied to most hospitalized patients.…”

Malnutrition Screening and Assessment

“…A recent study confirms the existing correlation of many of the above anthropometric data with length of hospital stay and the probability of patients returning to their regular residence on discharge [112,113].…”

Association of anthropometric z score with complications and length of hospital stay in children with severe pneumonia aged 3 months to 5 years

“…16 A Portuguese study found that patients who presented with values <25th percentile for triceps skinfold thickness and less than the fifth percentile for mid-upper arm circumference had a risk of prolonged LOS. 30 In the 2013 Guideline: Updates on the Management of Severe Acute Malnutrition in Infants and Children, the WHO recommends using midupper arm circumference at the community level to screen for severe acute malnutrition in children aged 6-59 months. 31 Mid-upper arm circumference is related to fat mass in children and is poorly related to fat-free mass and overall weight.…”