Body composition measures may help target fundamental nutritional nursing efforts in rehabilitating patients with acquired brain injury

Aadal, Lena; Odgaard, Lene; Nielsen, Jørgen Feldbæk; Rasmussen, Henrik Højgaard; Holst, Mette

doi:10.1002/nop2.981

Cited by 6 publications

(8 citation statements)

References 62 publications

(79 reference statements)

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“…The etiology of injury was primarily stroke (57%) and traumatic brain injury (26%). Habitual BMI was distributed with 37% normal BMI, 12% low BMI, and 52% high BMI 19 . The study was approved by the Danish Data Protection Agency.…”

Section: Methodsmentioning

confidence: 99%

“…Habitual BMI was distributed with 37% normal BMI, 12% low BMI, and 52% high BMI. 19 The study was approved by the Danish Data Protection Agency. Because data were gathered as an integrated part of daily practice, informed consent from patients or relatives as well as ethical approval was not required according to Danish legislation.…”

Section: Methodsmentioning

confidence: 99%

“…[12][13][14][15][16][17][18] In a recent study, we explored the use of BIA in patients with other types of ABI. 19 To facilitate future monitoring and development of nutritional nursing care, we in the current study use the data to describe the nutritional status at admission and after 4 weeks of subacute inpatient neurorehabilitation in patients with moderate to severe ABI using the GLIM criteria for the diagnosis of malnutrition.…”

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confidence: 99%

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Malnutrition in Patients With Moderate to Severe Acquired Brain Injury: Prevalence During 4 Weeks of Subacute Rehabilitation

Aadal

Holst

Rasmussen

et al. 2023

Journal of Neuroscience Nursing

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BACKGROUND: Malnutrition is associated with high rates of complication, longer hospital stays, and increased morbidity and mortality. Malnutrition defined as undernutrition is common in patients with acquired brain injury (ABI); however, estimates vary remarkably. This study aimed to describe malnutrition at admission and after 4 weeks of subacute inpatient neurorehabilitation in patients with ABI using the new global consensus definition of malnutrition. METHODS: One hundred thirty-three patients with moderate to severe ABI consecutively admitted to a specialized neurorehabilitation hospital within a period of 4 months were screened for inclusion, of which 92 were included. Malnutrition was defined as at least 1 phenotypic criterion (weight loss, low body mass index, low muscle mass) and at least 1 etiologic criterion (reduced food intake, inflammation). Malnutrition on admission and after 4 weeks was compared using the McNemar test. RESULTS:The proportion of patients with malnutrition at admission was 42%, with more men (46%) than women (36%) fulfilling the criteria for malnutrition. The most frequent phenotypic and etiologic criteria were weight loss (56%) and inflammation (74%), respectively. During the 4 weeks of rehabilitation, the proportion of male patients fulfilling the individual criteria "weight loss" (difference, −21.4%) and "inflammation" (difference, −18.9%) decreased significantly; "low muscle mass" decreased borderline significant (difference, −8.9%), whereas "low body mass index" did not change. The proportion of female patients fulfilling individual criteria for malnutrition was stable or increased nonsignificantly. CONCLUSION: Malnutrition was common at admission to neurorehabilitation in patients with moderate to severe ABI, with more men than women fulfilling the criteria for malnutrition. The nutritional status improved after 4 weeks of rehabilitation in male patients, whereas it was largely unchanged in female patients. The results provide the basis for monitoring high-quality nutritional nursing care.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Malnutrition in Patients With Moderate to Severe Acquired Brain Injury: Prevalence During 4 Weeks of Subacute Rehabilitation

Aadal

Holst

Rasmussen

et al. 2023

Journal of Neuroscience Nursing

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“…A testösszetétel-analizálás főként DEXAval történt; a BIA-n alapuló kutatásokban eltérő számú, illetve szimpla frekvenciával dolgozó és eltérő gyártóktól származó készülékeket használtak, amelyek mérési eltéréseket prezentáltak a testösszetétel becslésében [13]. Súlyos központi idegrendszeri sérültek esetében nemzetközi viszonylatban is rendkívül kevés, testösszetétellel kapcsolatos vizsgálat áll rendelkezésre, amelyek főként a funkcionalitással kapcsolatos szignifikáns összefüggéseket taglalják [14][15][16].…”

Section: Eredeti Közleményunclassified

A tápláltsági állapot bioimpedancia-alapú meghatározásának lehetősége a rehabilitációban

Tóth

Terjék

Nagy-Kónya

et al. 2022

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Összefoglaló. Bevezetés: Még nem rendelkezünk olyan malnutritiodiagnosztikai módszerrel, amellyel a rehabilitációs intézetek betegeinek tápláltsági állapotát és annak változását objektív, pontos, reprodukálható módon követni tudjuk. Célkitűzés: A vizsgálat célja az Országos Orvosi Rehabilitációs Intézet pácienseinek malnutritiorizikó-szűrése mellett a bioimpedancia-alapú testösszetétel meghatározása a megfelelő táplálás kialakítása érdekében. Módszer: Malnutritiorizikó-szűrésre a Nutrition Risk Screening 2002 kérdőívet használtuk. A testösszetétel-analizálást a multifrekvenciás bioimpedancia-alapú seca mBCA 525 készülékkel végeztük. Eredmények: 41 beteg felvételt követő, validált szűrőmódszerrel mért malnutritiorizikójának összefüggése a testtömegindexszel való evidens kapcsolatához (r = –0,662, p<0,001) képest gyengült a zsírmentes testtömegindexszel (r = –0,487, p = 0,001) és a vázizomtömeggel (r = –0,476, p = 0,002). A malnutritiorizikó a zsírtömeggel nem mutatott korrelációt. A testtömegindex erős összefüggései a testösszetétellel agysérültek esetében lényegesen gyengültek. A vázizom- és a zsírtömeg között erős összefüggést tapasztaltunk valamennyi esetben. A testtömegindex csak agysérültek esetén mutatott összefüggést az extracelluláris és a teljes testvíz arányával. A vízterek minden esetben erős összefüggést prezentáltak a fázisszöggel (r = –0,711, p<0,001). A fázisszög agysérültek esetében mutatta a legerősebb korrelációkat a zsírmentes testtömegindexszel (r = 0,638, p<0,001), valamint a vázizom- (r = 0,544, p<0,001) és zsírtömeggel (r = 0,588, p<0,001). Következtetés: A malnutritiót mérő skálák nem elég szenzitívek a rehabilitációs intézetek betegcsoportjaira, a testtömegindex-kalkulációval pedig kevesebb rizikós beteg szűrhető ki, mint a testösszetétel-mérésekkel. A rehabilitációs kórházak számára alkalmas módszernek tartjuk a szűrés kombinálását bioimpedancia-alapú testösszetétel-analizálással. Orv Hetil. 2022; 163(17): 670–676. Summary. Introduction: We do not have a diagnostic method for malnutrition yet that can monitor the nutritional status of patients in rehabilitation institutions and its changes in an objective, accurate, reproducible way. Objective: The aim of this study was to determine the risk of malnutrition in patients at the National Institute for Medical Rehabilitation of Hungary completing with bioimpedance-based body composition in order to develop adequate nutrition therapy. Method: The Nutritional Risk Screening 2002 questionnaire was used. Body composition analysis was determined by the multifrequency bioimpedance-based seca mBCA 525 device. Results: The association between the risk of malnutrition measured by a validated screening method of 41 patients was weaker with fat-free mass index (r = –0.487, p = 0.001) and skeletal muscle mass (r = –0.476, p = 0.002) than with body mass index (r = –0.662, p<0.001). It was not correlated with fat mass. Strong correlations of body mass index with body composition were significantly weakened in the case of brain injuries. A strong correlation between skeletal muscle and fat mass was observed in all cases. Body mass index correlated with extracellular and total body water ratio only in the case of brain injuries. The extracellular and total body water ratio presented a strong correlation with the phase angle in each case (r = –0.711, p<0.001). Phase angle showed the strongest correlations with fat-free mass index (r = 0.638, p<0.001), skeletal muscle (r = 0.544, p<0.001) and fat mass (r = 0.588, p<0.001) in the case of brain-injured patients. Conclusion: Malnutrition screening tools are not sensitive enough for patient groups of rehabilitation institutions, and with body mass index, less risky patients can be screened out than with body composition analysis. Combining screening with bioimpedance-based body composition analysis is a suitable method for rehabilitation hospitals. Orv Hetil. 2022; 163(17): 670–676.

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“…In patients with severe central nervous system injuries, there are few body composition studies and they mainly discuss significant correlations with functional status [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Changes in skeletal muscle mass index and fat mass index during rehabilitation for traumatic brain injury and stroke measured by bioelectrical impedance analysis

Tóth¹,

Dénes²,

Nemeth³

et al. 2023

International Journal of Rehabilitation Research

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Although malnutrition may negatively impact the outcomes of rehabilitation and increase the cost of care, there are still no valid nutritional assessment methods appropriate for specific groups of patients undergoing rehabilitation. This study aimed to determine if a multifrequency bioelectrical impedance is suitable for monitoring the changes in body composition of brain-injured patients for whom individualized nutritional goals were set during rehabilitation. Fat mass index (FMI) and skeletal muscle mass index (SMMI) were examined by Seca mBCA515 or portable Seca mBCA525 device within 48 h of admission and before discharge in 11 traumatic brain injury (TBI) and 11 stroke patients with admission Nutritional Risk Screening 2002 scores ≥2. The changes in outcomes and plausible interactions were examined between the admission values and the values estimated for the 18th day (minimum length of stay in the sample) using a repeated measure mixed-sample analysis of covariance. In patients with low FMI at admission (mainly younger, TBI patients, with longer ICU stay), there was no change over time whereas, in those with high admission FMI (older, stroke patients, with shorter ICU stay), a decrease was observed (significant interaction F(1,19) = 9.224 P = 0.007 Part. η² = 0.327). The SMMI significantly increased over time (F(1,19) = 5.202 P = 0.034 Part. η² = 0.215) independently of gender, age, days spent in ICU and cause of brain injury. Our results suggest that bioelectrical impedance analysis is feasible and informative for monitoring the changes in body composition during rehabilitation, which also requires consideration of demographic and pre-rehabilitation characteristics.

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Body composition measures may help target fundamental nutritional nursing efforts in rehabilitating patients with acquired brain injury

Cited by 6 publications

References 62 publications

Malnutrition in Patients With Moderate to Severe Acquired Brain Injury: Prevalence During 4 Weeks of Subacute Rehabilitation

Malnutrition in Patients With Moderate to Severe Acquired Brain Injury: Prevalence During 4 Weeks of Subacute Rehabilitation

A tápláltsági állapot bioimpedancia-alapú meghatározásának lehetősége a rehabilitációban

Changes in skeletal muscle mass index and fat mass index during rehabilitation for traumatic brain injury and stroke measured by bioelectrical impedance analysis

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