10 July 2013
The diagnostic accuracy of multi-frequency bioelectrical impedance analysis in diagnosing dehydration after stroke
Mohannad W. KafriABCDEFG, Phyo Kway MyintD, Danielle DohertyB, Alexander Hugh WilsonB, John F. PotterD, Lee HooperACDEGDOI: 10.12659/MSM.883972
Med Sci Monit 2013; 19:548-570
Abstract
BACKGROUND: Non-invasive methods for detecting water-loss dehydration following acute stroke would be clinically useful. We evaluated the diagnostic accuracy of multi-frequency bioelectrical impedance analysis (MF-BIA) against reference standards serum osmolality and osmolarity.
MATERIAL AND METHODS: Patients admitted to an acute stroke unit were recruited. Blood samples for electrolytes and osmolality were taken within 20 minutes of MF-BIA. Total body water (TBW%), intracellular (ICW%) and extracellular water (ECW%), as percentages of total body weight, were calculated by MF-BIA equipment and from impedance measures using published equations for older people. These were compared to hydration status (based on serum osmolality and calculated osmolarity). The most promising Receiver Operating Characteristics curves were plotted.
RESULTS: 27 stroke patients were recruited (mean age 71.3, SD10.7). Only a TBW% cut-off at 46% was consistent with current dehydration (serum osmolality >300 mOsm/kg) and TBW% at 47% impending dehydration (calculated osmolarity ≥295–300 mOsm/L) with sensitivity and specificity both >60%. Even here diagnostic accuracy of MF-BIA was poor, a third of those with dehydration were wrongly classified as hydrated and a third classified as dehydrated were well hydrated. Secondary analyses assessing diagnostic accuracy of TBW% for men and women separately, and using TBW as a percentage of lean body mass showed some promise, but did not provide diagnostically accurate measures across the population.
CONCLUSIONS: MF-BIA appears ineffective at diagnosing water-loss dehydration after stroke and cannot be recommended as a test for dehydration, but separating assessment by sex, and using TBW as a percentage of lean body weight may warrant further investigation.
Keywords: Osmolar Concentration, Electric Impedance, Dehydration - etiology, Body Water, Body Fluid Compartments - metabolism, Aged, 80 and over, ROC Curve, Stroke - complications
Editorial
01 June 2024 : Editorial
Editorial: Concerns as Highly Pathogenic Avian Influenza (HPAI) Virus of the H5N1 Subtype is Identified in Dairy Cows and Other MammalsDOI: 10.12659/MSM.945315
Med Sci Monit 2024; 30:e945315
In Press
Laboratory Research
Effect of Dentin Contamination with Hemostatic Agents and Cleaning Techniques on Bonding with Self-Adhesive...Med Sci Monit In Press; DOI: 10.12659/MSM.943353
Clinical Research
Undiagnosed and Untreated Peripheral Complications of Diabetes: Findings from a Pilot Study on Diabetes-Rel...Med Sci Monit In Press; DOI: 10.12659/MSM.944239
Laboratory Research
Molecular Prevalence and Geographical Variations of Carbapenem-Resistant Klebsiella pneumoniae ST15 Isolate...Med Sci Monit In Press; DOI: 10.12659/MSM.943596
Review article
Autism Spectrum Disorders: Etiology, Epidemiology, and Challenges for Public HealthMed Sci Monit In Press; DOI: 10.12659/MSM.944161
Most Viewed Current Articles
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952