Background: Phase Angle (PhA) value measured by bioelectrical impedance analysis (BIA) could be considered a good marker of the patient’s cell mass and cellular damage. Various studies have shown that the value of PhA is associated with an increased nutritional risk in several pathologies. However, not many studies have focused on the use of PhA as a screening tool in admitted patients. The aim of this study is to evaluate the prognostic value of PhA to determine disease-related malnutrition (DRM) and the risk that this entails for mortality and length of stay (LOS). Methods: 570 patients admitted to the hospital for different causes were included in this retrospective observational study. Patients’ nutritional risk was assessed by screening tests such as the Malnutrition Universal Screening tool (MUST) and Subjective Global Assessment (SGA), in addition to non-invasive functional techniques, such as BIA and handgrip strength (HGS), 24–48 h after admission. After performing an SGA as the gold standard to assess malnutrition, PhA and SPhA values were used to determine DRM. Furthermore, both samples: malnutrition status (MS) and non-malnutrition status (NMS) were compared, with SphA-Malnutrition corresponding to a diagnosis of malnutrition. Statistical analysis of the sample was conducted with JAMOVI version 2.2.2. Results: Patients with MS had lower PhA and SPhA than patients with NMS (p < 0.001). The ROC curve analysis (AUC = 0.81) showed a cut-off point for MS for PhA = 5.4° (sensitivity 77.51% and specificity 74.07%) and AUC = 0.776 with a cut-off point for SPhA = −0.3 (sensitivity 81.74% and specificity 63.53%). Handgrip strength (HGS) was also observed to be a good predictor in hospitalized patients. Carrying out a comparative analysis between MS and NMS, length of stay (LOS) was 9.0 days in MS vs. 5.0 days in NMS patients (OR 1.07 (1.04–1.09, p < 0.001)). A low SPhA-malnutrition value (SPhA < −0.3) was significantly associated with a higher mortality hazards ratio (HR 7.87, 95% CI 2.56–24.24, p < 0.001). Conclusion: PhA, SPhA and HGS are shown to be good prognostic markers of DRM, LOS and mortality and could therefore be useful screening tools to complement the nutritional assessment of admitted patients.

Background: The value of the phase angle (PhA), measured via bioelectrical impedance analysis (BIA), could be considered a good marker of the cell mass and the cell damage of a patient; however, there are new techniques, such as muscle ultrasonography, that allow the quantity and quality of muscle to be assessed in a minimally invasive way. The aim of this study is to determine the prognostic value of morphofunctional techniques in the prognosis of mortality in patients with idiopathic pulmonary fibrosis (IPF). Methods: This multicenter, cross-sectional study included 86 patients with idiopathic pulmonary fibrosis with a mean age of 71 years, 82.7% of whom were male. The nutritional risk of the patients was assessed by means of questionnaires, such as the Subjective Global Assessment (SGA), and non-invasive functional techniques, including BIA, nutritional ultrasound, and hand grip strength (HGS). Statistical analysis of the sample was performed using JAMOVI version 2.3.22. Results: Correlations were made between the RF-CSA techniques with PhA (r = 0.48, p < 0.001), BCM (r = 0.70, p < 0.001), SMI (r = 0.64, p < 0.001), and HGS (r = 0.54, p < 0.001). The cut-off points for 12-month mortality were PhA = 4.5° (AUC = 0.722, sensitivity of 72.7% and specificity of 66.6%), BCM = 28.8 kg (AUC = 0.609, sensitivity of 32.4% and specificity of 100.0%), RF-CSA = 3.00 cm² (AUC = 0.857, sensitivity of 64.4% and specificity of 100.0%), 6MMW = 420 m (AUC = 0.830, sensitivity of 63.27% and specificity of 100.0%), and TUG = 7.2 s (AUC = 0.771, sensitivity of 100.0% and specificity of 56.67%). In addition, a multivariate analysis was performed with RF-CSA, HR = 8.11 (1.39–47.16, p = 0.020), and PhA of 6.35 (1.29–31.15, p = 0.023), taking into account age, sex, and BMI to determine mortality. Finally, a Kaplan–Meier survival analysis was conducted with low or normal values for classical parameters (GAP and T6MM) and new parameters (PhA, BCM, RF-CSA, and TUG). Conclusion: RF-CSA and PhA were shown to be good prognostic markers of 12-month mortality and could, therefore, be useful screening tools to complement the nutritional assessment of IPF patients.

The application of validated pre-screening tools is crucial in clinical practice to identify patients at risk for disease. Bioelectrical Impedance Vector Analysis (BIVA) has gained recognition as a qualitative method for monitoring body composition and assessing the health status of hospitalized patients. This study investigates the utility of updated BIVA reference standards in evaluating malnutrition, sarcopenia, and mortality among hospitalized individuals. This retrospective observational study included 2.872 patients admitted to Quironsalud Málaga Hospital between January 2019 and January 2024. Malnutrition and sarcopenia were diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines. Mortality was defined as death within one year of their initial discharge or later admissions. BIVA was performed using the former and the new 50th, 75th, and 95th reference tolerance ellipses of general population. BIVA revealed significant differences in bioimpedance vectors between malnourished (n = 1187, 544 women) and non-malnourished patients, sarcopenic (n = 136, 51 women) and non-sarcopenic patients, and non-survivors (n = 317, 160 women) compared to survivors. When previous BIVA references (Piccoli 1995) were applied, the bioimpedance vectors for malnourished, sarcopenic, and non-surviving patients fell within the 75th tolerance ellipses. However, with updated references, these vectors shifted rightward, moving outside the 75th and 95th tolerance ellipses. Univariate Cox analysis showed that participants with vectors outside the new 95th tolerance ellipses faced significantly higher mortality risk (HR = 6.22 [95 % CI 4.40-8.80], p < 0.001) and lower survival rates (log-rank test p < 0.001) compared to those within the 75th ellipses. These trends persisted even after adjusting for age, sex, and BMI (HR = 4.79 [95 % CI 3.29-6.97], p < 0.001). The new reference ellipses demonstrated greater prognostic accuracy compared to the older ones, emphasizing their value in identifying high-risk patients. The implementation of BIVA with newly established reference tolerance ellipses significantly enhances the evaluation of body composition and overall health in hospitalized patients. These updated tolerance ellipses are instrumental in accurately identifying malnutrition, sarcopenia, and heightened mortality risks. The delineation of specific mortality risk zones underscores the potential of incorporating these advanced BIVA ellipses into routine pre-screening protocols, thereby optimizing clinical nutritional assessments and interventions.

Background/Objectives: Haematologic cancers, such acute leukaemia, lymphoma, and multiple myeloma, are associated with high morbidity and mortality rates, often exacerbated by malnutrition and functional decline. This study aims to evaluate the prognostic value of bioimpedance phase angle (PhA) and hand grip strength (HGS) as nutritional and clinical markers for predicting 12-month mortality in hospitalized patients with haematologic cancers. Methods: A retrospective observational study was conducted on 121 patients admitted to Hospital Quironsalud Málaga between January 2019 and June 2021. PhA was measured using bioelectrical impedance analysis (BIA) and HGS was assessed using a dynamometer. Nutritional status was evaluated through Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. The primary outcome was 12-month mortality, analysed using ROC curves, Kaplan–Meier survival estimates, and multivariate logistic regression models. Results: Lower PhA (<3.8° for females, <5.4° for males) and reduced HGS (<17 kg for females, <28 kg for males) were significantly associated with higher 12-month mortality (p < 0.001). The optimal PhA cut-off showed high sensitivity (85.5%) and specificity (62.2%). Multivariate analysis confirmed PhA as an independent predictor of mortality (OR = 0.417, p = 0.023). Patients with lower PhA and HGS values exhibited reduced survival rates, emphasizing the importance of these markers in clinical practice. Conclusions: PhA and HGS are reliable, non-invasive tools for assessing prognosis in haematologic cancer patients. Incorporating these markers into routine care could improve risk stratification, guide nutritional interventions, and enhance patient outcomes.

Introduction: Assessing the nutritional and morphofunctional status of patients with obesity (PwO) is essential for optimizing their management. Nutritional ultrasound (NU) is a noninvasive, portable technique that offers insights into muscle and adipose tissue status. Combining NU with bioelectrical impedance analysis (BIA) and handgrip strength (HGS) may improve the assessment of body composition and muscle functionality. This study aimed to evaluate the usefulness of NU as a primary tool for morphofunctional assessment in PwO while comparing and complementing it with BIA and HGS. Methods: A cross-sectional observational study was conducted including 178 PwO. Body composition was assessed using NU, single-frequency BIA, and HGS dynamometry. Correlations and multiple linear regression models were used to evaluate associations between NU, BIA, and HGS parameters. Results: Significant correlations were found between NU-measured quadriceps rectus femoris-cross-sectional area (RF-CSA) and BIA-derived fat-free mass markers, such as body cell mass (BCM) (r = 0.638, p < 0.001) and appendicular skeletal muscle mass (r = 0.591, p < 0.001). Additionally, leg subcutaneous adipose tissue measured by NU was highly correlated with BIA-calculated fat mass (r = 0.656, p < 0.001). Linear regression analyses further confirmed the importance of RF-CSA as a strong predictor of BCM, along with HGS and body mass index, explaining 78.2% of the variability in BCM (R2 = 0.782, Akaike Information Criterion = 672). Conclusion: These findings suggest that NU, combined with BIA and HGS, provides a comprehensive, practical tool for assessing body composition and muscle function in obesity management, with the potential for routine application in clinical settings.

Background/Objectives: Malnutrition is highly prevalent in patients with acute leukemia and is frequently underrecognized at diagnosis. Traditional screening tools based on anthropometry often fail to identify early nutritional deterioration. This study aimed to evaluate the prognostic utility of a comprehensive morphofunctional assessment—including bioelectrical impedance vector analysis (BIVA), handgrip strength (HGS), and muscle ultrasound—conducted at diagnosis and after induction therapy, to evaluate the prognostic association with 12-month mortality. Methods: In this prospective cohort study, 52 adult patients with newly diagnosed acute leukemia were enrolled between November 2022 and November 2024 at two tertiary hospitals in Málaga, Spain. Nutritional status was determined using GLIM criteria. Morphofunctional assessment included BIVA-derived phase angle (PhA), HGS via dynamometry, and rectus femoris ultrasound. A second evaluation was performed prior to haematopoietic stem cell transplantation. Mortality at 12 months was the primary outcome. Logistic regression and ROC analysis were used to assess prognostic associations. Results: At baseline, 65.4% of patients were classified as malnourished. After three months, patients showed significant declines in PhA (−0.55°, p < 0.001), body cell mass (−3.15 kg, p < 0.01), skeletal muscle mass (−1.66 kg, p < 0.01), and rectus femoris cross-sectional area (−0.36 cm², p = 0.011). Baseline malnutrition (OR = 6.88; 95% CI: 1.17–40.38; p = 0.033) and PhA decline ≥ 0.90° were both independently associated with higher 12-month mortality. Conclusions: Early morphofunctional assessment using GLIM criteria, BIVA, and muscle ultrasound identifies patients at nutritional and functional risk. PhA decline during treatment was associated with higher 12-month mortality, supporting the need for early, personalized nutritional intervention in leukemia care.