Body composition by bioelectrical impedance, muscle strength, and nutritional risk in oropharyngeal dysphagia patients

Abstract

Introduction: Oropharyngeal dysphagia (OD) has complications such as malnutrition and dehydration. Body composition is an important factor for nutritional status. Objective: To evaluate the presence of cachexia, phase angle, muscle strength, and nutritional risk according to the type of feeding regimen tolerated by patients, determined with the volume-viscosity swallow test (V-VST). Methods: This cross-sectional study included hospitalized adults of both sexes with a diagnosis of OD established by the Eating Assessment Tool and V-VST. Nutritional risk status was assesed using the Nutritional Risk Screening-2002 tool. Phase angle and cachexia were determined through bioelectrical impedance vector analysis (BIVA), and functional capacity through handgrip strength (HGS) and anthropometric parameters. Results: Seventy-nine patients with a median age of 73 years (56-79 yrs) were included; 79.9 % of patients were categorized at nutritional risk. According to the V-VST, 27 (34.2 %) patients tolerated nectar viscosity; 27 (34.2 %) belonged to the spoon-thick and 25 (31.6 %) to the exclusive tube feeding groups. In the exclusive tube feeding group a lower phase angle (3.7° ± 0.9) and lower HGS of 9 kg (5-15) were observed in comparison to the nectar and spoon-thick groups (in both, 4.6° ± 1.1, p = 0.005), which featured 20 kg (16-31) and 19 kg (14-26), respectively (p = 0.03). Conclusion: Nutritional risk was present in 79.9 % of the study population. BIVA allows to evaluate the integrity of muscle mass and tissue hydration, both related to phase angle. A lower phase angle and HGS were observed in the exclusive tube feeding group. These factors are considered important for prognosis.