Nutrition (Burbank, Los Angeles County, Calif.) · 2026
Pretransplant muscle status as a predictive marker for diarrhea duration and hospital length of stay in patients undergoing hematopoietic stem cell transplantation: a prospective cohort analysis.
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Song Anqi, Zhang Minyue, Cai Yongmei, Tang Molian, Shen Lijing, Xu Renying
Аннотация
OBJECTIVES: To examine the impact of pretransplant muscle status on diarrhea duration and length of stay (LOS) following hematopoietic stem cell transplantation (HSCT).
METHODS: This was a secondary analysis from a prospective study. All of the participants were adult HSCT inpatients between 2022 and 2024. Muscle status was evaluated using height-adjusted appendicular skeletal muscle mass (ASM) and handgrip. The patients were classified into two groups: "Group A": height-adjusted ASM above standard (≥ male 7.0 kg/m2, female 5.7 kg/m2) AND handgrip above standard (≥ male 28kg, female 18kg); "Group B": either height-adjusted ASM OR handgrip below above-mentioned standard. Diarrhea was defined as the passage of more than three loose stools daily, as per the Bristol Stool Chart, within 14 d of transplantation. LOS was defined as the number of days from the date of admission to discharge.
RESULTS: Overall, 96 patients (52.1% male) aged 52.7 ± 12.8 y were enrolled, of whom one-fourth had abnormal muscle status. After full adjustment for relevant confounders, a longer diarrhea duration was associated with abnormal muscle status (incidence rate ratio, 1.7, 95% confidence interval, 1.2-2.3, P = 0.002). Similarly, a longer LOS was associated with abnormal muscle status (incidence rate ratio, 1.3, 95% confidence interval, 1.1-1.5, P = 0.007). The association with diarrhea duration was consistent across conditioning therapy but more pronounced in patients with multiple myeloma or lower pretransplant protein intake.
CONCLUSIONS: Pretransplant muscle status was associated with the diarrhea duration within 14 d of transplantation and LOS in HSCT patients. These results support pretransplant nutritional assessment and early intervention to maintain muscle status.
METHODS: This was a secondary analysis from a prospective study. All of the participants were adult HSCT inpatients between 2022 and 2024. Muscle status was evaluated using height-adjusted appendicular skeletal muscle mass (ASM) and handgrip. The patients were classified into two groups: "Group A": height-adjusted ASM above standard (≥ male 7.0 kg/m2, female 5.7 kg/m2) AND handgrip above standard (≥ male 28kg, female 18kg); "Group B": either height-adjusted ASM OR handgrip below above-mentioned standard. Diarrhea was defined as the passage of more than three loose stools daily, as per the Bristol Stool Chart, within 14 d of transplantation. LOS was defined as the number of days from the date of admission to discharge.
RESULTS: Overall, 96 patients (52.1% male) aged 52.7 ± 12.8 y were enrolled, of whom one-fourth had abnormal muscle status. After full adjustment for relevant confounders, a longer diarrhea duration was associated with abnormal muscle status (incidence rate ratio, 1.7, 95% confidence interval, 1.2-2.3, P = 0.002). Similarly, a longer LOS was associated with abnormal muscle status (incidence rate ratio, 1.3, 95% confidence interval, 1.1-1.5, P = 0.007). The association with diarrhea duration was consistent across conditioning therapy but more pronounced in patients with multiple myeloma or lower pretransplant protein intake.
CONCLUSIONS: Pretransplant muscle status was associated with the diarrhea duration within 14 d of transplantation and LOS in HSCT patients. These results support pretransplant nutritional assessment and early intervention to maintain muscle status.