Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study

Nutrients. 2023 Jan 25;15(3):612. doi: 10.3390/nu15030612.

Abstract

Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions.

Keywords: Delphi; GRADE; clinical practice; feasibility; malnutrition; morphofunctional assessment.

Publication types

  • Systematic Review

MeSH terms

  • Consensus
  • Delphi Technique
  • Hand Strength*
  • Humans
  • Malnutrition* / complications
  • Malnutrition* / diagnosis
  • Quality of Life
  • Reproducibility of Results

Grants and funding

This study was supported by Persan Farma. The sponsor had no role in study design, study development, data collection and analysis, or in the writing of this manuscript.