Value of body mass index in the detection of severe malnutrition: influence of the pathology and changes in anthropometric parameters

Campillo, Bernard; Paillaud, Éléna; Uzan, I.; Merlier, Isabelle; Abdellaoui, M.; Perennec, J.; Louarn, F.; Bories, Phuong Nhi

doi:10.1016/j.clnu.2003.10.003

Cited by 90 publications

(52 citation statements)

References 20 publications

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“…However, BMI may be unreliable in the presence of confounding factors such as oedema or ascites, and may not identify significant unintentional weight loss if used as a single assessment. 17,25,26 Furthermore, reliable measurement of height can be difficult in the elderly because of vertebral compression, loss of muscle tone and postural changes. 17,27 For this reason, some screening tools use alternatives such as measurement of ulna length.…”

Section: Body Mass Index (Bmi)mentioning

confidence: 99%

Malnutrition screening in the elderly population

Harris

Haboubi

2005

Journal of the Royal Society of Medicine

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Section: Body Mass Index (Bmi)mentioning

confidence: 99%

Malnutrition screening in the elderly population

Harris

Haboubi

2005

Journal of the Royal Society of Medicine

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“…The body mass index (BMI) is another simple indicator of the nutritional state. Although values between 18.5 and 24.9 kg/m², 19 considered eutrophic, less than 20 kg/m² are indicative of malnutrition and associated to a significant increase of mortality in different types of patients [10]. An unintentional loss of body mass greater than 10% in the last six months or a more rapid loss are prognostic of clinical evolution21 and classical signs of malnutrition.2 However, it may be difficult to determine the real loss of body mass in sick individuals, because of poor accuracy [11].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Nutritional Status and Prognosis in Surgical Intensive Care Unit: The Prognostic and Inflammatory Nutritional Index (PINI)

Gharsallah¹

2014

IJNFS

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Background Malnutrition is an independent factor of morbidity and mortality in patients at intensive care unit.The prognostic inflammatory and nutritional index (PINI) is frequently used as a marker of malnutrition but this scoring system was not studied in surgical intensive care units. The purposes of this study were to assist nutritional status with biomarkers and to search for a correlation between biological markers and prognosis, using the PINI. Methods A prospective, observational study was performed in the intensive care unit, started in July 2013. Twenty surgical patients, spent at least seven days at the intensive care unit were enrolled. An early nutritional care was given (first 24 hours). The patients were evaluated each week clinically and biologically (Albumin, Prealbumin, Orosomucoid, C-reactive protein) in order to establish the prognostic inflammatory and nutritional index (PINI = C-reactive protein x Orosomucoid / Albumin x Prealbumin). The correlation between variables was calculated, the Spearman rank-order correlation was used. Results The average age was 56+/-11 years, IGS II score was 48+/-17, APACHE II score was 25+/-12 and MODS ratio was 6+/-4. The mean duration of stay was 40+/-25 days, the mortality rate was 35%. The average calorie intake was 2300+/-600 kcal. There was a weight gain and an increase of the Body Mass Index either in surviving and dead patients. There was an initial increase of the C-reactive protein and the orosomucoid rate during the acute phase of aggression followed by a progressive decrease. The nutritional proteins (albumin, prealbumin, retinol binding protein) were always low, despite a progressive increase. The PINI was initially high and decreased progressively but remained high (> 20).The Albumin and Prealbumin rate were correlated with the MODS ratio. There was a correlation between the orosomucoid rate and the organ failure. The PINI was correlated to the MODS ratio and to the IGS II but not with mortality. Conclusions The malnutrition in surgical patients at intensive care unit has an early onset and is always severe. Biological markers and PINI are correlated with organ failure but not with mortality.

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“…Patients were defined as moderately undernourished if they met the following criteria: BMI 20.01-22 and/or 5-10% unintentional weight loss in the past six months (21)(22)(23)(24)(25)(26)(27).…”

Section: Definition Of Severe and Moderate Undernutritionmentioning

confidence: 99%