Disease-related malnutrition (DRM) can occur when there is a deficient supply of energy, protein and/or other nutrients, depending on the nutritional needs of each individual at different times of their life cycle or health or disease circumstances. This deficiency induces effects on body composition and tissue and organ function and results in clinical consequences: increased morbidity and mortality associated with different disease processes. There are techniques for nutritional assessment using assessment tools aimed at morphofunctional diagnosis of malnutrition, in addition to the classical nutritional parameters, such as weight loss, BMI, folds, circumferences, albumin, lymphocytes, cholesterol and intake. New advanced parameters are being incorporated into clinical nutrition and their incorporation into clinical practice is of increasing interest, such as measures derived from bioelectrical impedance (BIA) and phase angle (PhA), dynamometry, functional tests, CRP/prealbumin ratio and muscle ultrasound. In 2019, the GLIM criteria were published, providing a different vision of how to assess the malnourished patient. Phenotypic criteria include reduction in muscle mass (measured using validated techniques to measure body composition). The objective of the study is to highlight nutritional ultrasound for measuring muscle and functional status in order to make a more accurate diagnosis and a better prediction of complications and morbidity and mortality in this type of patients.
Prospective, multicenter, uncontrolled clinical study, of routine clinical practice, without drugs or medical devices
Study Type
OBSERVATIONAL
Enrollment
1,000
Servicio de Endocrinología y Nutrición. Complejo Hospitalario Universitario de Ferrol, A Coruña.
A Coruña, Spain
RECRUITINGHospital Universitario de Badajoz
Badajoz, Spain
RECRUITINGHospital Universitario Vall d´Hebron
Barcelona, Spain
RECRUITINGHospital Universitario de Basurto
Bilbao, Spain
RECRUITINGHospital Universitario Puerta del Mar
Cadiz, Spain
RECRUITINGHospital Universitario Reina Sofía
Córdoba, Spain
RECRUITINGHospital Universitario de Cabueñes
Gijón, Spain
RECRUITINGHospital Universitario Virgen de las Nieves
Granada, Spain
RECRUITINGHospital Universitario de Jaén
Jaén, Spain
RECRUITINGComplejo Hospitalario Uni. Insular - Materno Infantil
Las Palmas de Gran Canaria, Spain
RECRUITING...and 15 more locations
Nutritional ultrasound measurements: ultrasound with 4-10 cm linear probe.
* Abdominal ultrasound: total, superficial and pre-peritoneal adipose tissue (measured in centimetres). * Muscle ultrasound: Area, circumference, axes and adipose tissue (measured in centimetres)
Time frame: Patients will be followed over a period of 6 consecutive months
Sociodemographic data:
Age
Time frame: Patients will be followed over a period of 6 consecutive months
Sociodemographic data:
Sex
Time frame: Patients will be followed over a period of 6 consecutive months
Sociodemographic data:
Educational level
Time frame: Patients will be followed over a period of 6 consecutive months
Sociodemographic data:
Toxic habits
Time frame: Patients will be followed over a period of 6 consecutive months
Sociodemographic data:
Medical history
Time frame: Patients will be followed over a period of 6 consecutive months
Sociodemographic data:
Risk of sarcopenia and moderate to high malnutrition based on MUST and SARC-F screening test using R-MAPP.
Time frame: Patients will be followed over a period of 6 consecutive months
Subjective Global Assessment (SGA)
SGA questionnaire. SGA rank indicates the patient's nutritional status according to 3 categories: (1) well nourished, (2) moderate or suspected malnutrition, and (3) severe malnutrition.
Time frame: Patients will be followed over a period of 6 consecutive months
Anthropometric data:
Current body weight (measured or estimated)
Time frame: Patients will be followed over a period of 6 consecutive months
Anthropometric data:
Usual weight
Time frame: Patients will be followed over a period of 6 consecutive months
Anthropometric data:
Adjusted weight (adjusted weight in obese subjects, dry weight without oedema in malnourished subjects)
Time frame: Patients will be followed over a period of 6 consecutive months
Anthropometric data:
Height (measured or estimated)
Time frame: Patients will be followed over a period of 6 consecutive months
Anthropometric data:
BMI (body mass index)
Time frame: Patients will be followed over a period of 6 consecutive months
Anthropometric data:
Arm circumference
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
TBW (total body water, L),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
ECW (extracellular water, L),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
ICW (intracellular water, L),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
FFM (lean mass, kg),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
FM (fat mass, kg),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
BCM (body cell mass, kg),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
ASMM (appendicular skeletal muscle mass, kg),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
SMI (skeletal muscle mass index, kg),
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
Percent hydration.
Time frame: Patients will be followed over a period of 6 consecutive months
Bioelectrical impedance data (model (50 kHz):
% body fat
Time frame: Patients will be followed over a period of 6 consecutive months
Blood biochemistry data (at baseline visit, at 3 and 6 months):
albumin
Time frame: Patients will be followed over a period of 6 consecutive months
Blood biochemistry data (at baseline visit, at 3 and 6 months):
prealbumin
Time frame: Patients will be followed over a period of 6 consecutive months
Blood biochemistry data (at baseline visit, at 3 and 6 months):
C-reactive protein
Time frame: Patients will be followed over a period of 6 consecutive months
Blood biochemistry data (at baseline visit, at 3 and 6 months):
total cholesterol
Time frame: Patients will be followed over a period of 6 consecutive months
Blood biochemistry data (at baseline visit, at 3 and 6 months):
lymphocytes
Time frame: Patients will be followed over a period of 6 consecutive months
Functional parameters:
Timed Up and Go test (TUG): patient sits in a chair and is told to get up (timing starts), walks 3 meters, comes back and sits in the initial chair (timing ends). Interpretation: \<20 seconds: normal,\> 20 seconds: increased risk of falling.
Time frame: Patients will be followed over a period of 6 consecutive months
Functional parameters:
Dynamometry. Three measurements of the dominant hand will be made recording the mean and maximum, measured in kilograms. Jamar® dynamometers are most used in international studies and have several grip positions.
Time frame: Patients will be followed over a period of 6 consecutive months
Current patient status:
Hospital stay, mortality at 3 and 6 months, hospital readmissions and complications. The complications occurring and their consequences (resolved/unresolved) must be recorded in the form.
Time frame: Patients will be followed over a period of 6 consecutive months
Adherence.
Attendance to study follow-up visits.
Time frame: Patients will be followed over a period of 6 consecutive months
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