Body composition analysis and handgrip strength as predictors of 12-month mortality in hospitalized adults receiving parenteral nutrition: A descriptive cohort study

Abstract

Background Nutrition assessment in patients receiving parenteral nutrition often relies on classical parameters with limited prognostic value. Morphofunctional tools such as phase angle and handgrip strength measurement offer a more comprehensive evaluation of nutrition status and may better predict clinical outcomes. Objective To evaluate the predictive value of phase angle and handgrip strength for 12-month mortality in hospitalized patients receiving parenteral nutrition. Methods A retrospective observational study was conducted in 614 patients treated with parenteral nutrition. Anthropometric assessments were realized. Morphofunctional assessments included bioelectrical impedance analysis to determine phase angle and dynamometry to measure handgrip strength. Survival analysis was performed using Cox proportional hazards models and Kaplan-Meier curves and cutoff values by receiver operating characteristic curve analysis. Results Six hundred fourteen patients received parenteral nutrition, with a mean age of 64 ± 14.6 years; 58.2% were male. After 1 year, the mortality rate was 26.1%, and the average hospital stay was 27.9 ± 23.8 days. Twelve-month survival was reduced in patients with low phase angle (57%) and low handgrip strength (62.8%) compared with those with preserved values (84% and 82.2%, respectively). In the multivariable logistic regression model adjusted for age, sex, and body mass index, each unit increase in phase angle and handgrip strength was associated with a 4% and 2% reduction in mortality odds, respectively (phase angle: odds ratio [OR], 0.6; 95% CI, 0.5–0.7; P < 0.001; handgrip strength: OR, 0.9; 95% CI, 0.9–1.0; P = 0.03624). Conclusion Phase angle and handgrip strength are predictors of 12-month mortality in patients receiving parenteral nutrition.