Clinical impact of disease-related malnutrition and fluid overload assessment via bioimpedance vector analysis in hospitalized patients

Background: This cohort study assessed the effect of disease-related malnutrition (DRM) and fluid overload (FO) evaluated by bioimpedance vector analysis (BIVA) on mortality among hospitalized patients. Methods: We examined adult patients hospitalized in an internal medicine ward. The malnutrition risk was assessed using the NRS2002 questionnaire, and body composition was estimated via BIVA. Clinical, epidemiological, and laboratory characteristics were compared between patients with and without DRM by BIVA (DRM-B). The effect of DRM and FO by BIVA on mortality was assessed via logistic regression analysis. Results: The study included 130 adult patients (62.3% men) with a mean age of 63 +/- 19 years. Malnutrition risk at hospital admission was present in 43.8%. According to BIVA, 63.1% had normal body composition, 27.7% had DRM, and 9.2% obesity while FO was present in 53.1%. Patients with DRM-B were older (70 +/- 16 vs. 61 +/- 20 years, p = 0.05) and had a higher prevalence of cerebrovascular disease than patients without DRM-B (11% vs. 0%, p = 0.001). The overall mortality rate was 8.5% (n = 11) and was higher among patients with DRM-B than among those without DRM-B (16.7% vs. 5.3%, p = 0.03). No differences existed in mortality between patients with and without FO (8.7% vs. 8.2%, p = 0.91). DRM-B was associated with higher mortality rates adjusted for FO and comorbidities (odds ratio = 3.7, 95% confidence interval: 1.01-13.53, p = 0.04). Conclusion: DRM and FO by BIVA were very frequent in our population. DRM-B was associated with a higher mortality rate, which emphasizes the importance of evaluating body composition in hospitalized patients. (c) 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.