Prognostic Impact of Malnutrition Evaluated via Bioelectrical Impedance Vector Analysis (BIVA) in Acute Ischemic Stroke: Findings from an Inverse Probability Weighting Analysis

被引：0
作者：
Dal Bello, Simone [1 ,2 ]
Ceccarelli, Laura [1 ,2 ]
Tereshko, Yan [1 ,3 ]
Gigli, Gian Luigi [1 ,2 ]
D'Anna, Lucio [4 ,5 ]
Valente, Mariarosaria [1 ,2 ]
Merlino, Giovanni [1 ,2 ,3 ]
机构：
[1] Santa Maria Misericordia Univ Hosp, Clin Neurol Unit, I-33100 Udine, Italy
[2] Univ Udine, Dept Med Area, I-33100 Udine, Italy
[3] Azienda Sanit Univ Friuli Cent ASUFC, Dept Head Neck & Neurosci, SOSD Stroke Unit, I-33100 Udine, Italy
[4] Imperial Coll Healthcare NHS Trust, Charing Cross Hosp, Dept Stroke & Neurosci, London W2 1NY, England
[5] Imperial Coll London, Dept Brain Sci, London SW7 2AZ, England
来源：
NUTRIENTS | 2025年 / 17卷 / 05期
关键词：
BIA; BIVA; Bioelectrical Impedance Analysis; Bioelectrical Impedance Vector Analysis; ischemic stroke; BODY-MASS INDEX; BIOIMPEDANCE ANALYSIS; PHASE-ANGLE; FAT;
D O I：
10.3390/nu17050919
中图分类号：
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号：
100403 ;
摘要：
Background. The association between malnutrition and poor outcomes in stroke patients has, to date, been evaluated using composite scores derived from laboratory measurements. However, Bioelectrical Impedance Analysis (BIA) and its advanced application, Bioelectrical Impedance Vector Analysis (BIVA), offer a non-invasive, cost-efficient, and rapid alternative. These methods enable precise assessment of body composition, nutritional status, and hydration levels, making them valuable tools in the clinical evaluation of stroke patients. Objective. This study aimed to compare the ordinal distribution of modified Rankin Scale (mRS) scores at 90 days following an acute ischemic stroke, stratifying patients based on their nutritional status at the time of Stroke Unit admission, as determined by the Bioelectrical Impedance Vector Analysis (BIVA) malnutrition parameter. Methods. We conducted a single-centre prospective observational study on all consecutive patients admitted for acute ischemic stroke to our Stroke Unit between 1 April 2024, and 30 September 2024. We applied the IPW (Inverse Probability Weighting) statistical technique and ordinal logistic regression to compare mRS scores in malnourished and non-malnourished patients. Results. Overall, our study included 195 patients with ischemic stroke assessed using BIVA. Of these, 37 patients (19%) were malnourished. After IPW, we found that malnourished patients had significantly lower rates of favorable 90-day functional outcomes (cOR 3.34, 95% CI 1.74-6.41; p = 0.001). Even after accounting for relevant covariates, malnutrition remained an independent predictor of unfavorable outcomes (acOR 2.79, 95% CI 1.37-5.70; p = 0.005), along with NIHSS score at admission (acOR 1.19, 95% CI 1.11-1.28; p < 0.001), intravenous thrombolysis (acOR 0.28, 95% CI 0.15-0.52; p < 0.001), absolute lymphocyte count (cOR 1.01, 95% CI 1.00-1.02; p = 0.027), and albumin concentration (cOR 0.82, 95% CI 0.75-0.89; p < 0.001). Conclusions. Malnutrition, assessed through Bioelectrical Impedance Vector Analysis (BIVA) at the time of admission to the Stroke Unit, is associated with worse clinical outcomes at 90 days following the ischemic cerebrovascular event.
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页数：12
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