BIA nutritional status assessment the present sasessment, we established optimal cut-offs specific asdessment head and neck surgical patients in an Asian context. To help us improve our website we would like to know why you do not find this page useful. Prior to surgery, patients were evaluated in a preoperative multidisciplinary allied health professional clinic.

BIA nutritional status assessment -

Due to patient privacy policies of the institution, the authors are unable to give characteristics of those who refused to be included in the study.

Prior to surgery, patients were evaluated in a preoperative multidisciplinary allied health professional clinic. Subjective Global Assessment SGA scores were evaluated by certified dieticians on 61 patients prior to surgery and patients were identified as either well nourished, moderately malnourished or severely malnourished.

Bioelectrical impedance analysis measuring phase angles and Wellness marker values was performed using the Bodystat Quadscan in 53 patients prior to surgery. Statistical analysis was performed with R version 4.

Receiver operating characteristic ROC curves were plotted to analyse the area under the curves AUC. Optimal cut-off values of Wellness marker and phase angle for predicting malnutrition and perioperative pneumonia were obtained according to the Youden Index YI.

The mean ± SD age was 62 ± 1. Most patients The remaining patients were diagnosed with adenoid cystic carcinoma, carcinoma ex pleomorphic adenoma, osteosarcoma, and undifferentiated nasopharyngeal carcinoma respectively.

Based on the SGA scoring, 24 Patient characteristics and nutritional status determined by SGA are summarised in Table I. The mean ± SD value of phase angle recorded was 5. Other parameters recorded from BIA, including individual components of fat, muscle and water masses as a percentage of total body weight are summarised in Table I.

The mean ± SD duration of stay was 21 ± 19 days. In the course of their hospital stay, 21 Specifically, 6 developed pneumonia, 9 patients developed surgical site infections, 2 patients developed salivary leak or had fistula formation and 7 patients had flap complications.

None of the patients suffered acute myocardial infarctions or cerebrovascular accidents and there were no deaths recorded during admission. The optimal phase angle cut-off in predicting for moderate and severe malnutrition was below 4.

sensitivity Fig I shows the receiver operating characteristic ROC curve of phase angle and Wellness marker for detecting malnutrition respectively.

Both phase angle AUC: 0. The optimal phase angle cut off in predicting for perioperative pneumonia was below 5. Fig II shows the receiver operating characteristics ROC curve for phase angle and Wellness marker in predicting for development of perioperative pneumonia.

Both phase angle AUC 0. In our study, we found that a sizeable proportion of patients undergoing surgery for head and neck malignancies were malnourished Patients suffering from head and neck malignancies are especially susceptible to developing malnutrition because of impaired metabolism from disease processes, poor oral intake due to symptoms such as dysphagia, anorexia, mucositis, xerostomia and taste alterations.

Multiple cohort studies have demonstrated association between SGA scores and BIA parameters in healthy subjects 25 , hospital in-patients 15 and surgical patients.

Bioimpedance analysis can provide valuable information on nutritional status via the determination of phase angles, which is a measure of cell membrane integrity and vitality and hence reliably reflects cellular health.

For instance, higher body fat percentages in Asians compared to Caucasian counterparts of the same BMI presents significant challenges in comparing between studies. In the present study, we established optimal cut-offs specific to head and neck surgical patients in an Asian context.

It may also be relevant for use in patients with head and neck squamous cell carcinoma, as these patients form the majority Further studies will be required to validate and refine the values reported.

The Wellness marker is a relatively newer parameter introduced only in more modern BIA systems and differs from phase angle measurements in that no predictive equations are required. To our knowledge, there are no other studies on malnutrition with Wellness marker measurements. Our study also established that BIA predicts development of perioperative pneumonia.

Several other studies have also demonstrated the role of BIA in predicting complications. BIA does not readily predict for the latter complications as they are often multifactorial and are likely more dependent on risk factors such as type of surgery, previous irradiation and other technical factors, which varies greatly between individuals.

On the contrary, malnutrition has been strongly associated with pneumonia; protein calorie malnutrition has been found to impair pulmonary cell-mediated immunity processes and clearance of pathogens, resulting in increased incidence, severity and duration of pulmonary infections in malnourished individuals.

The value of BIA has evolved greatly since it was validated for use in assessing human body composition in While it has achieved wide acceptance in its use globally 39 , SGA lacks sensitivity to detect acute changes in nutritional status. The limitations of our study include a small patient cohort size from a single institution and the lack of long term follow up data.

In addition, the type of peri-operative pneumonia and subsequent interventions these patients received have not been discussed within the scope of this paper. Further research may be required to determine cost effectiveness and practicality of BIA for routine use in an institutional setting.

Bioelectrical Impedance Analysis is associated with Subjective Global Assessment, and can be used in assessing preoperative nutritional status for patients undergoing surgery for head and neck malignancies.

BIA shows promise as a preoperative tool, in conjunction with SGA to detect malnutrition in patients undergoing head and neck surgery and highlight patients at risk of developing perioperative pneumonia.

Data cannot be shared publicly because of patient privacy policies of the institution. Data are available from the SingHealth Centralised Institutional Review Board CIRB for researchers who meet the criteria for access to confidential data.

S1 File. Strengthening the Reporting of Observational Studies in Epidemiology STROBE Checklist for cohort studies. View the discussion thread. Skip to main content. Bioelectrical Impedance Analysis in the nutritional assessment and prediction of complications in patients undergoing surgery for head and neck malignancies, A pilot observational study View ORCID Profile Lai Yi Ting , Peh Hui Yee , View ORCID Profile Hanis Binte Abdul Kadir , Lee Chun Fan , N.

Gopalakrishna Iyer , Wong Ting Hway , Gerald Tay Ci An. Lai Yi Ting. Abstract Background Patients with head and neck malignancies are especially vulnerable to developing malnutrition, which has a significant impact on morbidity and mortality.

Introduction Despite major advancements in healthcare, malnutrition remains ubiquitous in patients worldwide.

Materials and Methods A prospective study was carried out on 61 patients out of a total of 97 patients scheduled for major head and neck oncological surgery in a tertiary hospital in Singapore from to Results Patient characteristics 45 males and 16 females aged ranging from 25 to 88 years old were included in the study.

Prevalence of malnutrition Based on the SGA scoring, 24 View this table: View inline View popup Download powerpoint. Table I. Baseline patient characteristics. BIA parameters The mean ± SD value of phase angle recorded was 5. Table II: Phase angle and Wellness marker differences across SGA groups.

Fig 1. Receiver Operating Characteristic ROC curve of phase angle and wellness marker for detecting malnutrition. Table III: Phase angle and Wellness marker differences in patients who developed perioperative complications.

Fig 2. Receiver Operating Characteristic ROC curve of phase angle and wellness marker for predicting the development of perioperative pneumonia. Discussion In our study, we found that a sizeable proportion of patients undergoing surgery for head and neck malignancies were malnourished Conclusion Bioelectrical Impedance Analysis is associated with Subjective Global Assessment, and can be used in assessing preoperative nutritional status for patients undergoing surgery for head and neck malignancies.

Data Availability Data cannot be shared publicly because of patient privacy policies of the institution. Supporting Information S1 File. References 1. Prevalence of Malnutrition in Hospitalized Patients: a Multicenter Cross-sectional Study.

J Korean Med Sci. Pirlich M , Schütz T , Norman K , Gastell S , Lübke HJ , Bischoff SC , et al. The German hospital malnutrition study. Clin Nutr. OpenUrl CrossRef PubMed Web of Science.

Löser C. Malnutrition in hospital: the clinical and economic implications. Dtsch Arztebl Int. OpenUrl PubMed. Lim SL , Ong KC , Chan YH , Loke WC , Ferguson M , Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality.

OpenUrl CrossRef PubMed. Barker LA , Gout BS , Crowe TC. Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system. Int J Environ Res Public Health. Middleton MH , Nazarenko G , Nivison-Smith I , Smerdely P.

Single-frequency BIA SF-BIA With this method the resistance R can be measured at one frequency 50 kHz. For healthy people this measurement is adequate. For sick people, however, especially when there is a imbalance in fluid compartments, this measurement is not advised.

With a SF-BIA measurement it is not possible to measure intracellular ICW and extracellular water ECW separately. Clinical depletion is characterised by a decrease of ICW, often in combination with ECW expansion.

Only with the data from TBW, it is not possible to determine the loss of body cell mass. Nutritional Assessment in a clinical setting is required for quantification of both fluid compartments.

Multi-frequency BIA MF-BIA This method measures the impedance at different frequencies. At low frequencies the current will only go through ECW because the cell membranes and contact area between the tissues act like condensators.

At high frequencies this quality does not work and the current will go through ECW and ICW. Resistance measured at low and high frequencies are used to calculate ECW and TBW based on the resistance index at specific frequencies.

Bioelectrical impedance spectroscopy BIS This is a more theoretical approach. It uses extrapolated resistance values at zero and infinite frequency Rinf by use of the Cole-Cole model. The model assumes a parallel arrangement of the ECW and ICW. This method provides resistance values for intracellular water Ricw and extracellular water Recw.

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Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Volume 8 Supplement 2. Background Based on our recent data, nutritional status disturbances both under- and overweight can be associated with the severity of scoliotic curve.

Purpose The study objective was to compare two methods for the assessment of nutritional status BMI vs. Methods For a total of IS patients girls and 77 boys , mean age Results Nutritional status assessed by BMI has been associated with Conclusions and discussion Nutritional status classification by BMI assessment overestimates the underweight and leads to the underestimation of both overweight and obese patients with IS.

References Matusik E, Durmala J, Matusik P, Piotrowski P: Evaluation of nutritional status of children and adolescents with idiopathic scoliosis: a pilot study. Article PubMed Google Scholar Grivas TB, Arvaniti A, Maziotou C, Manesioti MM, Ferqadi A: Comparison of body weight and height between normal and scoliotic children.

PubMed Google Scholar McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM: Body fat reference curves for children. Article CAS Google Scholar Download references. View author publications. Rights and permissions This article is published under license to BioMed Central Ltd.

Background Patients nutritionap head Physical activity levels neck malignancies statu especially Natural weight loss secrets to developing malnutrition, which has a Anti-cancer motivation impact on Citrus supplement for digestive health and Nutditional. Identification hutritional high risk patients is hence assedsment for optimising outcomes. Objective It is stattus that bioimpedance analysis BIA can nutrritional information on nutritional status and risk of perioperative complications in a timely and accurate manner. The study objectives are; to correlate BIA parameters with Subjective Global Assessment SGA scores, and determine the association of BIA parameters with common perioperative complications in patients undergoing head and neck surgery. Method This is a cohort study of 61 patients who were admitted for elective head and neck surgery from Prior to surgery, patients were evaluated in a preoperative multidisciplinary allied health professional clinic for formal SGA scoring. Bioelectrical impedance analysis was performed using the Bodystat Quadscan Scoliosis sttatus Physical activity levelsArticle number: O35 Cite aassessment article. Metrics details. Based on Citrus supplement for digestive health recent data, nutritional status disturbances both under- and overweight can be associated with the severity of scoliotic curve. The study objective was to compare two methods for the assessment of nutritional status BMI vs. BIA-body composition analysis by bioelectrical impedance analyzer in IS patients. For a total of IS patients girls and 77 boysmean age

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