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  • 1
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    Online Resource
    GLIM criteria for malnutrition diagnosis of hospitalized patients presents satisfactory criterion validity: A prospective cohort study
    Elsevier BV ; 2021
    In:  Clinical Nutrition Vol. 40, No. 6 ( 2021-06), p. 4366-4372
    Details
    In: Clinical Nutrition, Elsevier BV, Vol. 40, No. 6 ( 2021-06), p. 4366-4372
    Type of Medium: Online Resource
    ISSN: 0261-5614
    URL: Article
    DOI: 10.1016/j.clnu.2021.01.009
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2009052-3
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  • 2
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    Concurrent and Predictive Validity of AND‐ASPEN Malnutrition Consensus Is Satisfactory in Hospitalized Patients: A Longitudinal Study
    Wiley ; 2021
    In:  Journal of Parenteral and Enteral Nutrition Vol. 45, No. 5 ( 2021-07), p. 1061-1071
    Details
    In: Journal of Parenteral and Enteral Nutrition, Wiley, Vol. 45, No. 5 ( 2021-07), p. 1061-1071
    Abstract: Subjective Global Assessment (SGA) is the reference method to identify hospital malnutrition. The Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition (AND‐ASPEN) proposed a more objective consensus, but studies regarding its validity are still scarce. This study aimed to evaluate the concurrent and predictive validity of the AND‐ASPEN Consensus. Methods Prospective cohort conducted with hospitalized adult and elderly patients. At admission, general data were collected and patients were evaluated by SGA and AND‐ASPEN with and without handgrip strength (HGS) for nutrition diagnoses. Patients were followed up for collection of outcomes—length of hospital stay (LOS), in‐hospital death, readmission, and mortality within 6 months after being discharged. Concurrent and predictive validity were tested. Results Six hundred patients (55.7 ± 14.8 years, 51.3% males) were evaluated. The median of LOS was 10.0 (5.018.0) days and in‐hospital mortality was 2.7%. SGA identified 34.0% and AND‐ASPEN 34.6% of patients as malnourished. AND‐ASPEN had substantial agreement with SGA (κ = 0.690) and satisfactory accuracy (AUC = 0.85; 95% CI, 0.810.88). Malnutrition defined by AND‐ASPEN predicted about 1.4 times higher risk of prolonged LOS (95% CI, 1.2–1.6) and hospital readmission (95% CI, 1.2–1.8), besides 5.0 times higher risk of hospital death (95% CI, 1.3–18.8) and 6 months' death (95% CI, 2.6–9.9), in an adjusted analysis. The validity of AND‐ASPEN without HGS was also satisfactory. Conclusion AND‐ASPEN can be used for malnutrition diagnoses, even without HGS because it has satisfactory concurrent and predictive validity.
    Type of Medium: Online Resource
    ISSN: 0148-6071 , 1941-2444
    URL: Issue
    URL: Article
    DOI: 10.1002/jpen.v45.5
    DOI: 10.1002/jpen.1980
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2170060-6
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  • 3
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    Low‐cost and fast‐performing indicators of muscle mass loss are good predictors of clinical outcomes in hospitalized patients: A longitudinal observational study
    Wiley ; 2022
    In:  Journal of Parenteral and Enteral Nutrition Vol. 46, No. 4 ( 2022-05), p. 887-895
    Details
    In: Journal of Parenteral and Enteral Nutrition, Wiley, Vol. 46, No. 4 ( 2022-05), p. 887-895
    Abstract: “Gold standard” methods for muscle mass (MM) assessment are expensive and difficult to use in clinical practice. The present study aimed to evaluate the association between easy‐to‐apply and low‐cost indicators of MM and clinical outcomes in hospitalized patients. Methods In this cohort study, calf circumference [CC], adductor pollicis muscle thickness [APMT] , midarm muscle circumference [MAMC], and arm muscle area [AMA] were measured within 48 h of admission to detect MM loss, and it was also evaluated by physical examination. Patients were followed up until discharge for collection of in‐hospital death and length of hospital stay (LOS) data, and they were contacted by phone to assess hospital readmission and mortality at 6 months after discharge. Results We evaluated 601 patients (55.8 ± 14.8 years). Moderate/severe loss of MM (hazard ratio [HR], 4.12; 95% CI, 1.26–13.49), low CC (HR, 3.67; 95% CI: 1.07–12.55), low MAMC (HR, 5.20; 95% CI, 1.48–18.35), and low AMA (HR, 14.28; 95% CI, 1.80–113.14) were predictors of in‐hospital mortality. Moderate/severe loss of MM was a predictor of prolonged LOS (odds ratio [OR] , 2.27; 95% CI, 1.53–3.36), hospital readmission (OR, 4.14; 95% CI, 1.26–13.55), and mortality at 6 months (OR, 3.20; 95% CI, 1.71–6.01). Low CC (OR, 2.49; 95% CI, 1.27–4.85) and low APMT (OR, 3.22; 95% CI, 1.56–6.66) were associated with death 6 months after discharge. Conclusion Easy‐to‐apply and low‐cost indicators of MM were associated with negative clinical outcomes and should be part of nutrition assessment in hospitals
    Type of Medium: Online Resource
    ISSN: 0148-6071 , 1941-2444
    URL: Issue
    URL: Article
    DOI: 10.1002/jpen.v46.4
    DOI: 10.1002/jpen.2268
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2170060-6
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  • 4
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    Reduced Handgrip Strength in Hospital Admission Predicts Prolonged Hospital Stay and Death but Is Not Accurate to Identify Malnutrition: A Longitudinal Study of Reduced Handgrip Strength in Hospitalized Patients
    Wiley ; 2021
    In:  Journal of Parenteral and Enteral Nutrition Vol. 45, No. 5 ( 2021-07), p. 1016-1022
    Details
    In: Journal of Parenteral and Enteral Nutrition, Wiley, Vol. 45, No. 5 ( 2021-07), p. 1016-1022
    Abstract: Malnourished patients present impairment of functionality due to loss of strength and muscle mass. However, the validity of handgrip strength (HGS) in identifying malnutrition and its association with clinical outcomes in hospitalized patients requires investigation. Aims Evaluate the accuracy of HGS in identifying malnutrition, its association with clinical outcomes, and the change in HGS in the first 2 weeks of hospitalization. Methods A prospective cohort study with adult/elderly patients. Subjective Global Assessment (SGA) was applied in the first 48 hours for malnutrition diagnosis, and HGS was measured in this moment and after 7 and 14 days of hospital admission. HGS 〈 20 kg for females and 〈 30 kg for males was considered reduced. Outcomes of interest were prolonged hospital stay (LOS) and in‐hospital death. Results Six hundred patients (55.75 ± 14.78 years, 51.5% males) were included, 34.0% of them were malnourished (SGA‐B or SGA‐C), and 37.2% presented reduced HGS. The concordance between reduced HGS and SGA in malnutrition diagnosis was weak (κ = 0.192), and accuracy was not satisfactory (area under the receiver operating characteristic curve = 0.599 [95% CI, 0.551–0.648]). HGS did not change during the hospitalization. Reduced HGS increased by 1.2 times (95% CI, 1.03–1.40) the odds for prolonged LOS and 9.11 times (95% CI, 1.13–73.60) the risk of death. Conclusion Reduced HGS did not present satisfactory accuracy to identify malnutrition, and HGS did not change during the first 14 days of hospitalization, but was associated with prolonged LOS and in‐hospital death.
    Type of Medium: Online Resource
    ISSN: 0148-6071 , 1941-2444
    URL: Issue
    URL: Article
    DOI: 10.1002/jpen.v45.5
    DOI: 10.1002/jpen.1976
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2170060-6
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  • 5
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    Complementarity of nutritional screening tools to GLIM criteria on malnutrition diagnosis in hospitalised patients: A secondary analysis of a longitudinal study
    Elsevier BV ; 2022
    In:  Clinical Nutrition Vol. 41, No. 10 ( 2022-10), p. 2325-2332
    Details
    In: Clinical Nutrition, Elsevier BV, Vol. 41, No. 10 ( 2022-10), p. 2325-2332
    Type of Medium: Online Resource
    ISSN: 0261-5614
    URL: Article
    DOI: 10.1016/j.clnu.2022.08.022
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2009052-3
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  • 6
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    Increased energy and/or protein intake improves anthropometry and muscle strength in chronic obstructive pulmonary disease patients: a systematic review with meta-analysis on randomised controlled clinical trials
    Cambridge University Press (CUP) ; 2023
    In:  British Journal of Nutrition Vol. 129, No. 8 ( 2023-04-28), p. 1332-1349
    Details
    In: British Journal of Nutrition, Cambridge University Press (CUP), Vol. 129, No. 8 ( 2023-04-28), p. 1332-1349
    Abstract: Compromised nutritional status is associated with a poor prognosis in chronic obstructive pulmonary disease (COPD) patients. However, the impact of nutritional support in this group of patients is controversial. The present study systematically reviewed the effect of energy and or protein supplements or food fortification on anthropometry and muscle strength of COPD patients. We searched MEDLINE (PubMed), EMBASE, Cochrane Library and Scopus for all published randomised clinical trials without language restriction up to May 2021. Three reviewers performed study selection and data extraction independently. We judged the risk of bias by RoB 2 and the certainty of evidence by the GRADE approach. We included thirty-two randomised controlled trials and compiled thirty-one of them (1414 participants) in the random-effects model meta-analyses. Interventions were energy and/or protein oral nutritional supplements or food fortification added to the diet for at least one week. Pooled analysis revealed that nutritional interventions increased body weight (muscle circumference (MD) = 1·44 kg, 95 % CI 0·81, 2·08, I2 = 73 %), lean body mass (standardised mean difference (SMD) = 0·37; 95 % CI 0·15, 0·59, I2 = 46 %), midarm muscle circumference (MD = 0·29 mm 2 , 95 % CI 0·02, 0·57, I2 = 0 %), triceps skinfold (MD = 1·09 mm, 95 % CI 0·01, 2·16, I2 = 0 %) and handgrip strength (SMD = 0·39, 95 % CI 0·07, 0·71, I2 = 62 %) compared with control diets. Certainty of evidence ranged from very low to low, and most studies were judged with some concerns or at high risk of bias. This meta-analysis revealed, with limited evidence, that increased protein and/or energy intake positively impacts anthropometric measures and handgrip strength of COPD patients.
    Type of Medium: Online Resource
    ISSN: 0007-1145 , 1475-2662
    URL: Article
    DOI: 10.1017/S0007114522000976
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2016047-1
    SSG: 12
    SSG: 21
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  • 7
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    Decline of nutritional status in the first week of hospitalisation predicts longer length of stay and hospital readmission during 6-month follow-up
    Cambridge University Press (CUP) ; 2021
    In:  British Journal of Nutrition Vol. 125, No. 10 ( 2021-05-28), p. 1132-1139
    Details
    In: British Journal of Nutrition, Cambridge University Press (CUP), Vol. 125, No. 10 ( 2021-05-28), p. 1132-1139
    Abstract: Nutritional status (NS) monitoring is an essential step of the nutrition care process. To assess changes in NS throughout hospitalisation and its ability to predict clinical outcomes, a prospective cohort study with patients over 18 years of age was conducted. The Subjective Global Assessment (SGA) was performed within 48 h of admission and 7 d later. For each patient, decline in NS was assessed by two different methods: changes in SGA category and severe weight loss alone (≥2 % during the first week of hospitalisation). Patients were followed up until discharge to assess length of hospital stay (LOS) and in-hospital mortality and contacted 6 months post-discharge to assess hospital readmission and death. Out of the 601 patients assessed at admission, 299 remained hospitalised for at least 7 d; of those, 16·1 % had a decline in SGA category and 22·8 % had severe weight loss alone. In multivariable analysis, decline in SGA category was associated with 2-fold (95 % CI 1·06, 4·21) increased odds of prolonged LOS and 3·6 (95 % CI 1·05, 12·26) increased odds of hospital readmission at 6 months. Severe weight loss alone was associated with 2·5-increased odds (95 % CI 1·40, 4·64) of prolonged LOS. In conclusion, deterioration of NS was more often identified by severe weight loss than by decline in SGA category. While both methods were associated with prolonged LOS, only changes in the SGA predicted hospital readmission. These findings reinforce the importance of nutritional monitoring and provide guidance for further research to prevent short-term NS deterioration from being left undetected.
    Type of Medium: Online Resource
    ISSN: 0007-1145 , 1475-2662
    URL: Article
    DOI: 10.1017/S0007114520003451
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2016047-1
    SSG: 12
    SSG: 21
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  • 8
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    Prone position, time to reach nutrition target, and energy/protein achievement rate on the seventh day of intensive care unit stay in patients with COVID‐19: A cohort study
    Wiley ; 2023
    In:  Nutrition in Clinical Practice Vol. 38, No. 3 ( 2023-06), p. 609-616
    Details
    In: Nutrition in Clinical Practice, Wiley, Vol. 38, No. 3 ( 2023-06), p. 609-616
    Abstract: We aimed to evaluate the mean time to reach the energy (EAR) and protein (PAR) achievement rate among patients with coronavirus disease 2019 (COVID‐19) who did or did not undergo prone position (PP) therapy in the first week of their stay in the intensive care unit (ICU), and the interaction of these nutrition therapy indicators on the association between PP and clinical outcomes. Methods This cohort study used retrospective data collected from medical records of patients with COVID‐19 admitted to the ICU (≥18 years). We collected nutrition data, clinical information, prescription of PP, and its frequency during the first week, and clinical outcomes. Results PP therapy was administered to 75.2% of 153 patients (61.5 ± 14.8 years, 57.6% males) during the first week of their ICU stay. Patients who underwent PP reached nutrition therapy goals later (4 [3–6] vs 3 [2–4] days; P  = 0.030) and had lower EAR (91.9 ± 25.7 vs 101.6 ± 84.0; P  = 0.002) and PAR (88.0 ± 27.7 vs 98.1 ± 13.5; P  = 0.009) in comparison to those who did not receive PP. Grouping patients who underwent PP according to the EAR (≥70% or 〈 70%) did not show any differences in the incidence of ICU death, duration of mechanical ventilation, or ICU stay ( P   〉  0.05). Conclusions In this exploratory study, PP was associated with a delayed time to reach the nutrition target and the lowest EAR and estimated protein requirement on the seventh day of ICU stay in patients with COVID‐19. Permissive enteral nutrition prescription in patients who underwent PP was not associated with worse clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 0884-5336 , 1941-2452
    URL: Issue
    URL: Article
    DOI: 10.1002/ncp.v38.3
    DOI: 10.1002/ncp.10952
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2170063-1
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  • 9
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    SARC‐CalF tool has no significant prognostic value in hospitalized patients: A prospective cohort study
    Wiley ; 2021
    In:  Nutrition in Clinical Practice Vol. 36, No. 5 ( 2021-10), p. 1072-1079
    Details
    In: Nutrition in Clinical Practice, Wiley, Vol. 36, No. 5 ( 2021-10), p. 1072-1079
    Abstract: Screening of sarcopenia is proposed to identify patients who require the diagnosis of this condition. One of the proposed screening tools is Strength, Assistance with walking, Rise from a chair, Climb stairs, Fall and Calf Circumference (SARC‐CalF). However, evidence for its applicability, especially in a hospital setting, is scarce. Therefore, this study aimed to evaluate the association between “suggestive signs of sarcopenia using SARC‐CalF” and clinical outcomes. Methods Prospective cohort study with hospitalized patients aged ≥60 years was conducted, and they were evaluated within 48 h of admission using the SARC‐CalF tool. Calf circumference and handgrip strength were measured, and the “timed get up and go” test was performed in all patients. The outcomes for testing the predictive validity of SARC‐CalF were prolonged length of hospital stay, in‐hospital death, hospital readmission, and mortality in 6 months. Results Of the 554 patients (55.22 ± 14.91 years old, 52.9% males) evaluated, 17.3% were classified as having “suggestive signs of sarcopenia using SARC‐CalF.” In univariate analysis, “suggestive signs of sarcopenia using SARC‐CalF” was associated with in‐hospital death ( P = .002) and mortality in 6 months ( P = .004). However, in the multivariate analysis, these associations were not significant. Conclusion SARC‐CalF was not an independent predictor of clinical outcomes during the hospitalization neither in the following 6 months of discharge.
    Type of Medium: Online Resource
    ISSN: 0884-5336 , 1941-2452
    URL: Issue
    URL: Article
    DOI: 10.1002/ncp.v36.5
    DOI: 10.1002/ncp.10675
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2170063-1
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  • 10
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    Accuracy of three tools for malnutrition diagnosis in hospitalised patients: Comparison to subjective global assessment
    Wiley ; 2021
    In:  Journal of Human Nutrition and Dietetics Vol. 34, No. 6 ( 2021-12), p. 935-944
    Details
    In: Journal of Human Nutrition and Dietetics, Wiley, Vol. 34, No. 6 ( 2021-12), p. 935-944
    Abstract: Malnutrition is prevalent in hospital, and the Subjective Global Assessment (SGA) has been widely used for its identification. However, in the last decade, new tools were proposed by the Academy of Nutrition and Dietetics–American Society for Parenteral and Enteral Nutrition (AND‐ASPEN), European Society for Clinical Nutrition and Metabolism (ESPEN) and Global Leadership Initiative on Malnutrition (GLIM). The diagnostic test accuracy of these tools has been scarcely investigated. Thus, we aimed to compare the accuracy of AND‐ASPEN, ESPEN and GLIM for malnutrition diagnosis in hospitalised patients. Methods A cross‐sectional study was conducted with hospitalised patients aged ≥ 18 years from a five‐unit complex hospital. Malnutrition was diagnosed within 48 h of admission using SGA, AND‐ASPEN, ESPEN and GLIM. The accuracy of these tools was evaluated by the area under the receiver operating characteristic (AUROC) curve, considering SGA as reference, which was compared by the DeLong test. Results Six hundred patients (55.7 ± 14.8 years, 51.3% male) were evaluated. AND‐ASPEN [AUROC 0.846; 95% confidence interval (CI) = 0.810–0.883] and GLIM presented a satisfactory accuracy (AUROC 0.842; 95% CI, 0.807–0.877), whereas ESPEN had a substantially lower accuracy (AUROC, 0.572; 95% CI, 0.522–0.622). The AUROC of AND‐ASPEN and GLIM were not different from each other ( p  = 0.785) and both had significantly higher accuracy than ESPEN ( p   〈  0.001). AND‐ASPEN and GLIM presented sensitivity, specificity and negative predictive value 〉  80%, whereas ESPEN sensitivity was 〈  20%. Conclusions AND‐ASPEN and GLIM were accurate methods for diagnosing malnutrition and could be applied in hospitalised patients. By contrast, the ESPEN criteria had unsatisfactory accuracy.
    Type of Medium: Online Resource
    ISSN: 0952-3871 , 1365-277X
    URL: Issue
    URL: Article
    DOI: 10.1111/jhn.v34.6
    DOI: 10.1111/jhn.12907
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2006797-5
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