Body composition measures may help target fundamental nutritional nursing efforts in rehabilitating patients with acquired brain injury.
Lena Aadal, Lene Odgaard, Jørgen Feldbaek Nielsen and 2 others
PMID 34190414WHAT IT FOUND
Body composition measures alongside BMI showed more patients with acquired brain injury leaving malnutrition over 4 weeks, but many remained at risk and energy intake was often below calculated needs.
Key findings
01Using BMI and fat-free mass measures, malnutrition decreased from 86% to 80% among patients with low BMI and from 22% to 14% among patients with normal BMI over 4 weeks.
02Of 16 patients malnourished by body composition at admission, seven reached normal weight or normal underweight after 4 weeks; nine remained malnourished but fat-free mass index increased.
03Energy intake at admission was below 90% of calculated needs in four of five patients with low BMI and in five of 10 patients malnourished by body composition.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a second analysis of cohort data from one hospital, so the changes over 4 weeks cannot be separated from other rehabilitation input or patient selection. The paper describes nursing contributions and body composition changes, not a tested effect of nursing care. Many subgroup counts were small, such as five patients with low BMI after 4 weeks and 10 patients malnourished by body composition in the intake analysis. Bioimpedance analysis can be inaccurate when fluid balance is abnormal, and oedema or paralysis can affect measurements. Energy and protein needs were estimated with formulas, and the paper states that common formulas may be insufficient in this population. Malnutrition by BMI was defined as below 18.5, which misses moderate malnutrition under newer definitions. The study used only the phenotypic part of GLIM malnutrition criteria, not the full combination of phenotypic and etiologic criteria.
Declared interests
The authors declared no conflicts of interest, and the study received no financial support.
The easy way to misread this
Do not conclude that body composition measures or nursing care caused better nutrition. The study was a descriptive second analysis of cohort data from one hospital, and the authors' interpretation that good nutritional nursing care produced the changes is their argument, not a tested effect.