ArticleEuropean geriatric medicine2026
Muscle loss must be interpreted in the context of fluid imbalance: a dual-parameter model predicts functional outcomes after acute stroke.
Article in European geriatric medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo examine whether the coexistence of elevated extracellular water-to-total body water ratio (ECW/TBW) and low appendicular lean soft tissue index (ALSTI), a combined fluid-muscle phenotype, predicted poorer functional independence at hospital discharge.
findingsThe coexistence of high ECW/TBW and low ALSTI was associated with poorer functional independence at hospital discharge, whereas low ALSTI alone was not. MESSAGE: The interpretation of ALSTI in patients with acute stroke should consider ECW/TBW and that ALSTI with ECW/TBW is clinically useful in predicting prognosis. PURPOSE: We aimed to examine whether the coexistence of elevated extracellular water-to-total body water ratio (ECW/TBW) and low appendicular lean soft tissue index (ALSTI), a combined fluid-muscle phenotype, predicted poorer functional independence at hospital discharge.
methodsPatients aged ≥65 years with an acute stroke between 2021 and 2024 were included. Baseline body composition was measured using bioelectrical impedance analysis within one week of rehabilitation initiation. High ECW/TBW was defined as ≥0.400, and low ALSTI as <7.0 kg/m
resultsIn total, 560 patients were included in the analysis. The number of patients with high ECW/TBW and low ALSTI was 227 (49.4%). Multivariate logistic regression analysis showed that the coexistence of high ECW/TBW and low ALSTI at baseline was a significant associated with non-independence at discharge (odds ratio (OR) = 3.82, 95% confidence interval (CI) 2.00-7.32, P < 0.001), but low ALSTI alone was not (OR = 1.73, 95% CI 0.92-3.22, P = 0.086).
conclusionsBaseline coexistence of high ECW/TBW and low ALSTI, highlighting the importance of considering fluid imbalance in addition to muscle mass, was associated with for non-independence at hospital discharge in patients with acute stroke.
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