Comparison between Nutritional Risk Tools and Parameters Derived from Bioelectrical Impedance Analysis with Subjective Global Assessment

BackgroundNutritional risk and malnutrition are highly prevalent among hospitalized patients. As a result, several methods have been developed to produce an adequate nutritional diagnosis.ObjectiveWe aimed to assess the relationship between nutritional risk tools and parameters derived from bioelectrical impedance analysis with a Subjective Global Assessment (SGA).DesignA cross-sectional study was conducted from April to September 2010.Participants/settingThe study included 124 patients admitted to the Surgical Clinic I, University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil, to undergo elective surgery.Main outcome measuresWe utilized SGA and Nutritional Risk Screening 2002 (NRS 2002), Nutritional Risk Index (NRI), Fat-Free Mass Index (FFMI), Fat Mass Index (FMI), body cell mass as a percentage of the total weight (%BCM), and standardized phase angle (SPA).Statistical analysis performedThe agreement was tested by κ coefficient, while bivariate associations were tested by Mann-Whitney U test.ResultsPrevalence of nutritional risk by NRS 2002 and NRI or malnutrition by SGA, FFMI, FMI, %BCM, and SPA was 19.3%, 69.5%, 35.5%, 12.9%, 8.1%, 46.8%, and 4.8%, respectively. The best agreement was between SGA and NRS 2002 (κ=.490), possibly because they constitute similar instruments. Patients identified as malnourished by SGA (B+C) showed considerably lower values of FFMI, FMI, BCM, and SPA.ConclusionsThe results suggest that the NRS 2002 and parameters derived from bioelectrical impedance analysis identify patients with impaired nutritional status.