• Nutrition · Jan 2023

    Low phase angle in critically ill older patients is associated with late mortality: A prospective study.

    • Ricardo Schilling Rosenfeld, Maria Cristina Gonzalez, Sergio Miranda Freire, and Roberto Alves Lourenço.
    • Nutrition Support Team, Casa de Saude Sao Jose - Rede Santa Catarina, Rio de Janeiro, Brazil; Postgraduate Program in Medical Science - Rio de Janeiro State University, Rio de Janeiro, Brazil. Electronic address: ricardorosenfeld57@gmail.com.
    • Nutrition. 2023 Jan 1; 105: 111852111852.

    ObjectivesThe aim of this study was to ascertain the accuracy of phase angle (PhA) as a predictor of mortality during intensive care unit (ICU) stay (MICU) and at 28 (M28) and 60 d (M60) after ICU admission among patients aged >60 y.MethodsPatients aged >60 y who were under mechanical ventilation (MV) ≥48 h were included once they were hemodynamically stable. PhA was measured by single-frequency bioelectrical impedance analysis up to 48 h after admission. ICU prognostic scores, functional scale, and nutritional assessments were performed in the first 24 h. Patients were followed for 60 d after ICU admission.ResultsWe enrolled 102 patients into the present study. PhA was significantly higher (P < 0.001) in survivors at MICU, M28, and M60. Areas under the receiving operator characteristic curves for MICU, M28, and M60 were 0.77 (95% confidence interval [CI], 0.67-0.86), 0.71 (95% CI, 0.60-0.82), and 0.71 (95% CI, 0.60-0.81), respectively. The PhA cutoff to predict mortality was 3.29° for males at MICU, M28, and M60 and lower for females at M28 (2.63°) and M60 (3.01°). PhA better discriminated M60 than conventional prognostic scores. Logistic regression showed that even after controlling for other factors, PhA was a protective factor against late mortality. Survival analysis at 60 d revealed that low PhA was associated with lower median survival (18 versus 58 d; log-rank P < 0.001).ConclusionsLow PhA values are associated with higher late mortality and a short survival time at 60 d in critically ill older adults. Low PhA values can be considered a useful ICU prognostic score in similar populations.Copyright © 2022 Elsevier Inc. All rights reserved.

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