外科患者的相位角与营养状况评估参数之间的一致性和关联性。

Agreement and association between the phase angle and parameters of nutritional status assessment in surgical patients.

作者信息

Scheunemann L, Wazlawik E, Bastos J L, Ristow Cardinal T, Mayumi Nakazora L

机构信息

Federal University of Santa Catarina, Florianópolis, SC, Brazil.

出版信息

Nutr Hosp. 2011 May-Jun;26(3):480-7. doi: 10.1590/S0212-16112011000300008.

DOI:10.1590/S0212-16112011000300008

PMID:21892564

Abstract

BACKGROUND & AIMS: To assess the agreement and the association between phase angle (PA) and parameters of nutritional status in surgical patients.

METHODS

This was a cross-sectional study that involved 98 patients admitted for elective gastrointestinal or hernia repair surgery. The risk and nutritional status were evaluated through Nutritional Risk Screening 2002 (NRS 2002), Subjective Global Assessment (SGA), Body Mass Index (BMI) and Total Lymphocytes Count (TLC). These assessments were compared with the mean standardized PA (SPA), obtained by Bioelectrical Impedance Analysis (BIA). Statistical analysis included kappa coefficient, Student's t-test, Mann-Whitney test, and the construction of a ROC Curve.

RESULTS

The highest kappa agreement was obtained between the SPA and the SGA (0.27; CI95% 0.06-0.48). Malnourished patients diagnosed by NRS 2002, SGA and TLC had a significantly lower mean SPA as compared to those who were well-nourished. A cut-off point of 0.8 for SPA showed 82.6% (CI95% 65.0-100.0%) sensitivity and 40.6% (CI95% 23.0-58.2%) specificity.

CONCLUSION

The SPA presented weak agreement with the methods of nutritional assessment, as well as low specificity, and could not be recommended as a marker of nutritional status, despite the fact that the lowest values for SPA were found in malnourished patients.

摘要

背景与目的

评估手术患者的相位角（PA）与营养状况参数之间的一致性和关联性。

方法

这是一项横断面研究，纳入了98例因择期胃肠道或疝气修补手术入院的患者。通过营养风险筛查2002（NRS 2002）、主观全面评定法（SGA）、体重指数（BMI）和淋巴细胞总数（TLC）评估风险和营养状况。将这些评估结果与通过生物电阻抗分析（BIA）获得的平均标准化PA（SPA）进行比较。统计分析包括kappa系数、学生t检验、曼-惠特尼检验以及受试者工作特征曲线（ROC曲线）的构建。

结果

SPA与SGA之间的kappa一致性最高（0.27；95%置信区间0.06 - 0.48）。与营养良好的患者相比，经NRS 2002、SGA和TLC诊断为营养不良的患者平均SPA显著更低。SPA的截断值为0.8时，敏感性为82.6%（95%置信区间65.0 - 100.0%），特异性为40.6%（95%置信区间23.0 - 58.2%）。