Nursing School, Departament of Nutrition, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Medicine Faculty, Departament of Surgery, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Nutr Clin Pract. 2019 Jun;34(3):381-386. doi: 10.1002/ncp.10110. Epub 2018 Jun 5.
Different nutrition assessment tools in surgical cancer patients are used in clinical practice, which results in different prevalence rates of malnutrition. This may impact the interpretation of the association between nutrition status and clinical outcomes. Reduced standardized phase angle (SPA) values are associated with adverse outcomes in patients with cancer. Thus, it is important to assess the association of SPA with nutrition status and relate it to postoperative clinical outcomes.
This prospective observational study included 121 surgical cancer patients. Bioelectrical impedance analysis, subjective global assessment (SGA), anthropometric measurements, and assessment of muscle strength were used to provide nutrition diagnosis 1 day before surgery. The patients were followed for infectious and noninfectious postoperative complications from the first day after the operation until discharge or death.
The prevalence of malnutrition was higher according to SGA (63.6%). Patients with an SPA < -1.65 had a greater chance of being diagnosed as malnourished according to the SGA (3.66 [1.35-9.90]), midarm circumference (OR 4.24; CI95%; 1.72-10.43), midarm muscle area (OR 4.38; CI95%; 1.68-11.42), and low handgrip strength (3.84 [1.31-11.25]). Patients with an SPA < -1.65 presented with more infectious complications (OR 4.19; CI95%; 1.52-11.53), but there was no association between SPA and other outcomes or death. SPA was the only significant predictor of infectious complications (AUC, 0.61; 95% CI, 0.51-0.71).
SPA was associated with different nutrition status parameters, and it was able to predict postoperative infectious complications.
在外科癌症患者中，不同的营养评估工具在临床实践中被使用，这导致了营养不良的不同流行率。这可能会影响营养状况与临床结局之间关联的解释。降低的标准化相位角（SPA）值与癌症患者的不良结局相关。因此，评估 SPA 与营养状况的关联并将其与术后临床结局相关联是很重要的。
这项前瞻性观察性研究纳入了 121 例外科癌症患者。在手术前 1 天，使用生物电阻抗分析、主观整体评估（SGA）、人体测量学测量和肌肉力量评估来提供营养诊断。从手术的第一天开始，对患者进行感染和非感染性术后并发症的随访，直至出院或死亡。
根据 SGA，营养不良的患病率更高（63.6%）。SPA< -1.65 的患者根据 SGA 被诊断为营养不良的可能性更大（3.66[1.35-9.90]）、中臂围（OR 4.24；CI95%；1.72-10.43）、中臂肌肉面积（OR 4.38；CI95%；1.68-11.42）和低握力（3.84[1.31-11.25]）。SPA< -1.65 的患者发生感染性并发症的可能性更高（OR 4.19；CI95%；1.52-11.53），但 SPA 与其他结局或死亡之间没有关联。SPA 是感染性并发症的唯一显著预测因子（AUC，0.61；95%CI，0.51-0.71）。
SPA 与不同的营养状况参数相关，并且能够预测术后感染性并发症。
