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Nutritional assessment: lean body mass depletion at hospital admission is associated with an increased length of stay
Open accessAbstract
Background Low fat-free mass may be an independent risk factor for malnutrition that results in an increased length of hospital stay (LOS). Objectives The objectives were to compare differences in fat-free mass and fat mass at hospital admission between patients and healthy control subjects and to determine the association between these differences and the LOS. Design Patients (525 men, 470 women) were prospectively recruited at hospital admission. Height-corrected fat-free mass and fat mass (fat-free-mass index or fat-mass index; in kg/m2) were determined in patients at admission by bioelectrical impedance analysis and were compared with values for sex-, age-, and height-matched control subjects. Patients were classified as well-nourished, moderately depleted, or severely depleted on the basis of a Subjective Global Assessment questionnaire and a body mass index (in kg/m2) < or > 20. Results Low fat-free mass was noted in 37% and 55.6% of patients hospitalized 1-2 d and > 12 d, respectively. The odds ratios were significant for fat-free-mass index and were higher in patients with a LOS of > 12 d [men (odds ratio: 5.6; 95% CI: 3.1, 10.4), women (4.4; 2.3, 8.7)] than in those with a LOS of 1-2 d [men (3.3; 2.2, 5.0), women (2.2; 1.6, 3.1)]. Severe nutritional depletion was significantly associated only with a LOS > 12 d. Conclusion Fat-free mass and fat-free-mass index were significantly lower in patients than in control subjects. Because the fat-free-mass index is significantly associated with an increased LOS, provides nutritional assessment information that complements that from a Subjective Global Assessment questionnaire, and is a more sensitive determinant of the association of fat-free mass with LOS than is a weight loss > 10% or a body mass index < 20, it should be used to evaluate nutritional status.
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“Undernutrition has been linked to negative impacts on morbidity, hospital stay duration, quality of life, health care costs, and mortality [16,20,21,22,23].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [22]
In the citing paper
“The prevalence of undernutrition among older adults, patients with various chronic diseases, and hospitalized patients has continued to increase over time, with at least one-third of admitted adult patients being malnourished [16,17,20,21,22,23].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [22]
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Metadata
- Authors
- Pichard, C., Kyle, U. G., Morabia, A., Perrier, A., Vermeulen, B., & Unger, P.
- Affiliations
- University Hospital of Geneva (CH)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2004-04
- Volume
- 79
- Issue
- 4
- Pages
- 613-618
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2145092440
- Cited by
- 392
- References
- 33
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 4 · 2023: 12 · 2022: 15 · 2021: 20 · 2020: 25 · 2019: 19 · 2018: 24 · 2017: 12 · 2016: 26 · 2015: 25 · 2014: 27 · 2013: 18 · 2012: 41
- FWCI
- 8.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- lean body mass, fat-free mass, fat-free mass index, fat mass, malnutrition, length of hospital stay, nutritional assessment, hospitalization, bioelectrical impedance analysis, Subjective Global Assessment, body mass index, hospitalized patients
- MeSH terms
- Adipose Tissue, Aged, Female, Hospitalization, Humans, Length of Stay, Male, Middle Aged, Prospective Studies, Regression Analysis, Nutrition Assessment, Body Mass Index, Case-Control Studies, Electric Impedance, Malnutrition
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