Parameters of Bioelectrical Impedance Are Good Predictors of Nutrition Risk, Length of Stay, and Mortality in Critically Ill Patients: A Prospective Cohort Study.

Autor: Razzera EL; Porto Alegre Federal University of Health Sciences, Porto Alegre, Brazil., Marcadenti A; Postgraduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.; Institute of Research, Coracao Hospital, São Paulo, São Paulo, Brazil.; Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil., Rovedder SW; Porto Alegre Federal University of Health Sciences, Porto Alegre, Brazil., Alves FD; Centro Universitário Ritter dos Reis - Uniritter, Porto Alegre, Brazil., Fink JDS; Intensive Care Unit, Conceição Hospital Group, Porto Alegre, Brazil., Silva FM; Department of Nutrition and Postgraduate Program in Nutrition, Federal University of Health Sciences, Porto Alegre, Brazil.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2020 Jul; Vol. 44 (5), pp. 849-854. Date of Electronic Publication: 2019 Aug 18.
DOI: 10.1002/jpen.1694
Abstrakt: Background: Assessment of nutrition risk in the intensive care unit (ICU) is limited by characteristics of critically ill patients, and new methods have been investigated for their applicability and predictive validity. The aim of the present study was to evaluate the validity of bioelectrical impedance analysis (BIA) parameters as predictors of nutrition risk and clinical outcomes in critically ill patients.
Methods: This was a prospective cohort study of patients admitted to an ICU. The modified Nutrition Risk in the Critically Ill score was used for assessment of nutrition risk, and BIA was performed in the first 72 hours of admission. Phase angle (PA) measurements were obtained, and bioelectrical impedance vector analysis (BIVA) was used to classify patients by hydration status (BIVA >70%). Patients were followed until hospital discharge and evaluated for hospital mortality, ICU length of stay, length of hospitalization, and duration of mechanical ventilation.
Results: Eighty-nine patients were included (62.5 ± 14.1 years, 50.6% female). A PA <5.5 o showed an accuracy of 79% (95% CI 0.59-0.83) in identifying patients at high nutrition risk and was associated with nearly 2 times greater risk for an ICU length of stay longer than 5 days (relative risk = 2.18 [95% CI 1.39-3.40]). Hyperhydration was a significant predictor of mortality (hazard ratio = 2.24 [95% CI 1.07-4.68]). Higher resistance and reactance values, adjusted for height, were found in survivors compared with nonsurvivors.
Conclusion: The predictive validity of BIA was satisfactory for the assessment of nutrition risk, ICU length of stay, and mortality in critically ill patients.
(© 2019 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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