• Nutrition · Feb 2022

    Observational Study

    Bioelectrical impedance vector analysis in patients on the waiting list for liver transplant: Associated factors and prognostic effects.

    • Bárbara Chaves Santos, Lívia Garcia Ferreira, Helem Sena Ribeiro, CorreiaMaria Isabel Toulson DavissonMITDSurgery Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Alfa Institute of Gastroenterology, Hospital das Clínicas-Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Agnaldo Soares Lima, Francisco Guilherme Cancela E Penna, and Lucilene Rezende Anastácio.
    • Food Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
    • Nutrition. 2022 Feb 1; 94: 111528.

    ObjectivesThe aim of this study was to assess patients on the waiting list for liver transplant (LTx) according to bioelectrical impedance vector analysis (BIVA), as well as to verify the association between the placement of the vectors on the graph with clinical outcomes and identify the predictors to vector placement in quadrant 4 (Q4; indicating more hydration and less cellularity).MethodsThis was a retrospective observational study including 129 patients ≥20 y of age awaiting LTx. Patients' nutritional status was assessed by using different tools, including single-frequency bioelectrical impedance analysis and the Subjective Global Assessment (SGA). Clinical data were registered. The BIVA was evaluated by comparing the individual vectors plotted for all patients to the tolerance ellipses of 50%, 75%, and 95% of the reference healthy population. The quadrant of the vector for each patient was registered.ResultsThe majority of the vectors were placed in Q1 (n = 54; 41.9%) and Q4 (n = 39; 30.2%). The presence of ascites or edema (hazard ratio [HR], 2.43; 95% confidence interval [CI], 1.15-5.12; P = 0.019) and the BIVA vector placed in Q4 in any ellipse (HR, 2.10; 95% CI, 1.07-4.09; P = 0.029) were independent predictors for mortality on the waiting list or ≤1 y after LTx. BIVA was not associated with longer hospital length of stay. The predictors of vector placement in Q4 were higher age, malnutrition according to SGA, and presence of ascites or edema.ConclusionPatients on the waiting list for LTx with BIVA vectors placed in Q4, in the 50%, 75%, or 95% tolerance ellipses, presented a worse prognosis.Copyright © 2021 Elsevier Inc. All rights reserved.

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