Clinical Applications of Body Composition and Functional Status Tools for Nutritional Assessment of Hospitalized Adults: A Systematic Review

Introduction: No global consensus exists on diagnostic criteria for malnutrition. Muscular deficits and functional impairments are major components of available malnutrition diagnostic frameworks (SGA, MCC, EDC, GLIM), because these facets of nutritional status significantly impact outcomes. The purpose of this review is to explore which body composition (BCA) and functional status assessment (FSA) tools are being used for nutritional assessment (NA) and monitoring response to nutritional interventions (RNI) in adult inpatients. Methods: A literature search of Embase, Medline (Ovid), Web of Science and Cochrane Central was performed to identify studies that utilized BCA and/or FSA tools for NA (along with an accepted NA diagnostic framework) and/or for monitoring RNI in adult inpatients. Results: The search yielded 3,667 articles; 94 were included in the review. The number of studies using BCA and/or FSA tools for NA was 47, and for monitoring RNI was also 47. 79% of studies used bioimpedance for BCA and 97% that included FSA utilized hand-grip strength. When compared against sets of diagnostic criteria, many of the BCA and FSA tools showed promising associations with nutritional status. Conclusions: Bioimpedance methods are the most widely used bedside BCA tools, and HGS is the most widely used FSA tool; however, these methods are being used with a variety of protocols, algorithms, and interpretation practices in heterogeneous populations. In order to create a standardized NSA process there is a need for validation studies on bedside methods and development of globally standardized assessment protocols in clinical inpatient settings. This article is protected by copyright. All rights reserved.