Skip to main content
Have a personal or library account? Click to login
Predictive ability of malnutrition screening tools in enterally fed, mechanically ventilated patients with phase angle inference: A prospective observational study Cover

Predictive ability of malnutrition screening tools in enterally fed, mechanically ventilated patients with phase angle inference: A prospective observational study

Open Access
|Apr 2026

References

  1. Lima J, Brizola Dias AJ, Burgel CF, Bernardes S, Gonzalez MC, Silva FM. Complementarity of nutritional screening tools to GLIM criteria on malnutrition diagnosis in hospitalised patients: A secondary analysis of a longitudinal study. Clin Nutr. 2022;41(10):2325–32.
  2. Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36(1):49–64.
  3. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159–211.
  4. Dixit SB, Tiwari NR, Zirpe KG, Tolat AG, Khatib KI, Kulkarni AP, et al. How Have Nutrition Practices in the ICU Changed in the Last Decade (2011–2020): A Scoping Review. Cureus. 2021;13(6):e15422.
  5. Chapple LS, Deane AM, Heyland DK, Lange K, Kranz AJ, Williams LT, et al. Energy and protein deficits throughout hospitalization in patients admitted with a traumatic brain injury. Clin Nutr. 2016;35(6):1315–22.
  6. Lew CC, Yandell R, Fraser RJ, Chua AP, Chong MF, Miller M. Association between malnutrition and clinical outcomes in the Intensive Care Unit: A systematic review. JPEN J Parenter Enteral Nutr. 2017;41(5):744–58.
  7. Koontalay A, Suksatan W, Sadang JM, Prabsangob K. Optimal Nutritional Factors Influencing the Duration of Mechanical Ventilation Among Adult Patients with Critical Illnesses in an Intensive Care Unit. J Multidiscip Healthc. 2021;14:1385–93.
  8. Huber O. Hospitalized mechanically ventilated patients are at higher risk of enteral underfeeding than non-ventilated patients. Clinical Nutrition. 2006;25(5):727–35.
  9. Al-Kalaldeh M, Alghabeesh S, Suleiman K, Abu-Sharour L. Assessment of Nutritional Status of Critically Ill Patients Using the Malnutrition Universal Screening Tool and Phase Angle. Top Clin Nutr. 2018;33(2):134–43.
  10. Cahill NE, Murch L, Cook D, Heyland DK. Improving the Provision of Enteral Nutrition in the Intensive Care Unit: A Description of a Multifaceted Intervention Tailored to Overcome Local Barriers. Nutr Clin Pract. 2014;29(1):110–7.
  11. Al-Kalaldeh M, Shosha GA, Shoqirat N, Alsaraireh M, Haddadin R. Estimating the time point for nutritional failure in patients suffering from acute brain attacks in the intensive care unit. Br J Nurs. 2021;30(21):S12–S9.
  12. Crossfield CL, Russo PL, Bucknall TK. Enteral nutrition feeding practices by intensive care nurses: A retrospective evaluation. Nurs Crit Care. 2021.
  13. Serón-Arbeloa C, Labarta-Monzón L, Puzo-Foncillas J, Mallor-Bonet T, Lafita-López A, Bueno-Vidales N, et al. Malnutrition Screening and Assessment. Nutrients. 2022;14(12).
  14. Sremanakova J, Burden S, Kama Y, Gittins M, Lal S, Smith CJ, et al. An Observational Cohort Study Investigating Risk of Malnutrition Using the Malnutrition Universal Screening Tool in Patients with Stroke. J Stroke Cerebrovasc Dis. 2019;28(12):104405.
  15. Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional Risk Screening and Assessment. J Clin Med. 2019;8(7).
  16. Chapple LA, Chapman MJ, Lange K, Deane AM, Heyland DK. Nutrition support practices in critically ill head-injured patients: a global perspective. Crit Care. 2016;20:6.
  17. Papadimitriou-Olivgeris M, Panteli E, Koutsileou K, Boulovana M, Zotou A, Marangos M, et al. Predictors of mortality of trauma patients admitted to the ICU: a retrospective observational study. Braz J Anesthesiol. 2021;71(1):23–30.
  18. Yalçın N, Kaşıkcı M, Çelik HT, Demirkan K, Yiğit Ş, Yurdakök M. Development and validation of machine learning-based clinical decision support tool for identifying malnutrition in NICU patients. Sci Rep. 2023;13(1):5227.
  19. Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Group AHEW. Nutritional risk screening (NRS 2002): A new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22:321–36.
  20. Kalaiselvan, M.S, Renuka MK, Arunkumar AS. Use of Nutrition Risk in Critically ill (NUTRIC) Score to Assess Nutritional Risk in Mechanically Ventilated Patients: A Prospective Observational Study. Indian J Crit Care Med. 2017;21(5):253–6.
  21. Wu H, Ding P, Wu J, Yang P, Tian Y, Zhao Q. Phase angle derived from bioelectrical impedance analysis as a marker for predicting sarcopenia. Front Nutr. 2022;9:1060224.
  22. Di Vincenzo O, Marra M, Sacco AM, Pasanisi F, Scalfi L. Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review. Clin Nutr. 2021;40(9):5238–48.
  23. Siedler MR, Rodriguez C, Stratton MT, Harty PS, Keith DS, Green JJ, et al. Assessing the reliability and cross-sectional and longitudinal validity of fifteen bioelectrical impedance analysis devices. Br J Nutr. 2023;130(5):827–40.
  24. Mueller TC, Reik L, Prokopchuk O, Friess H, Martignoni ME. Measurement of body mass by bioelectrical impedance analysis and computed tomography in cancer patients with malnutrition - a cross-sectional observational study. Medicine (Baltimore). 2020;99(50):e23642.
  25. Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences. 9th ed. New Jersey: John Wiley & Sons, Inc; 2009.
  26. Todorovic V, Russell C, Elia M. The ‘MUST’ Explanatory Booklet: A Guide to the ‘Malnutrition Universal Screening Tool’ (MUST) for Adults 2011.
  27. de Vries MC, Koekkoek WK, Opdam MH, van Blokland D, van Zanten AR. Nutritional assessment of critically ill patients: validation of the modified NUTRIC score. Eur J Clin Nutr. 2018;72(3):428–35.
  28. Al-Kalaldeh M, Suleiman K, Al-Kalaldeh O. Prognostic Performance of NUTRIC Score in Quantifying Malnutrition Risk in the Critically Ill in Congruence With the Bioelectrical Impedance Analysis. Nutr Clin Pract. 2020;35(3):559–66.
  29. Da Porto A, Tascini C, Peghin M, Sozio E, Colussi G, Casarsa V, et al. Prognostic Role of Malnutrition Diagnosed by Bioelectrical Impedance Vector Analysis in Older Adults Hospitalized with COVID-19 Pneumonia: A Prospective Study. Nutrients. 2021;13(11).
  30. Han SR, Bae JH, Lee CS, Al-Sawat A, Park SJ, Lee HJ, et al. Serial measurements of body composition using bioelectrical impedance and clinical usefulness of phase angle in colorectal cancer. Nutr Clin Pract. 2022;37(1):153–66.
  31. Cornejo-Pareja I, Vegas-Aguilar IM, García-Almeida JM, Bellido-Guerrero D, Talluri A, Lukaski H, et al. Phase angle and standardized phase angle from bioelectrical impedance measurements as a prognostic factor for mortality at 90 days in patients with COVID-19: A longitudinal cohort study. Clin Nutr. 2022;41(12):3106–14.
  32. Osuna-Padilla IA, Rodríguez-Moguel NC, Rodríguez-Llamazares S, Aguilar-Vargas A, Casas-Aparicio GA, Ríos-Ayala MA, et al. Low phase angle is associated with 60-day mortality in critically ill patients with COVID-19. JPEN J Parenter Enteral Nutr. 2022;46(4):828–35.
  33. Del Giorno R, Quarenghi M, Stefanelli K, Capelli S, Giagulli A, Quarleri L, et al. Nutritional Risk Screening and Body Composition in COVID-19 Patients Hospitalized in an Internal Medicine Ward. Int J Gen Med. 2020;13:1643–51.
  34. Lee YH, Lee JD, Kang DR, Hong J, Lee JM. Bioelectrical impedance analysis values as markers to predict severity in critically ill patients. J Crit Care. 2017;40:103–7.
  35. Besculides M, Mazumdar M, Phlegar S, Freeman R, Wilson S, Joshi H, et al. Implementing a Machine Learning Screening Tool for Malnutrition: Insights From Qualitative Research Applicable to Other Machine Learning-Based Clinical Decision Support Systems. JMIR Form Res. 2023;7:e42262.
  36. Talukder A, Ahammed B. Machine learning algorithms for predicting malnutrition among under-five children in Bangladesh. Nutrition. 2020;78:110861.
  37. Sharma V, Khan A, Wassmer DJ, Schoenholtz MD, Hontecillas R, Bassaganya-Riera J, et al. Malnutrition, Health and the Role of Machine Learning in Clinical Setting. Front Nutr. 2020;7:44.
  38. Al-Kalaldeh M, Shahin M. Nurses’ knowledge and responsibility toward nutritional assessment for patients in intensive care units. Journal of Health Sciences. 2014;4(1):1–7.
  39. Altintas ND, Aydin K, Turkogglu MA, Abbasogglu O, Topeli A. Effect of enteral versus parenteral nutrition on outcome of medical patients requiring mechanical ventilation. Nutr Clin Pract. 2011;26(3):322–9.
  40. Aloy Dos Santos T, Luft VC, Souza GC, de Albuquerque Santos Z, Keller Jochims AM, Carnevale de Almeida J. Malnutrition screening tool and malnutrition universal screening tool as a predictors of prolonged hospital stay and hospital mortality: A cohort study. Clin Nutr ESPEN. 2023;54:430–5.
  41. Sharma Y, Avina P, Ross E, Horwood C, Hakendorf P, Thompson C. Validity of the Malnutrition Universal Screening Tool for Evaluation of Frailty Status in Older Hospitalised Patients. Gerontol Geriatr Med. 2022;8:23337214221107817.
  42. Stello BB, Cattani A, Milanez DSJ, Razzera EL, Lima J, Silva FM. Prognostic value of different cut-off points of the NRS-2002 tool to identify nutritional risk in critically ill patients: a longitudinal study. Br J Nutr. 2023;130(8):1357–65.
  43. Ohashi Y, Otani T, Tai R, Tanaka Y, Sakai K, Aikawa A. Assessment of body composition using dry mass index and ratio of total body water to estimated volume based on bioelectrical impedance analysis in chronic kidney disease patients. J Ren Nutr. 2013;23(1):28–36.
  44. Stapel SN, Looijaard WGPM, Dekker IM, Girbes ARJ, Weijs PJM, Oudemans-van Straaten HM. Bioelectrical impedance analysis-derived phase angle at admission as a predictor of 90-day mortality in intensive care patients. Eur J Clin Nutr. 2018;72(7):1019–25.
DOI: https://doi.org/10.62838/jccm-2026-0010 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 232 - 242
Submitted on: May 26, 2025
Accepted on: Jan 29, 2026
Published on: Apr 30, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Mahmoud Al-Kalaldeh, Mohammad Abu Sabra, Omar Al-Kalaldeh, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.