Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Institute of Biomedicine, University of Southern Switzerland, Lugano, Switzerland.
Section of Clinical Nutrition and Dietetics, Department of Internal Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Nutrition. 2021 May;85:111068. doi: 10.1016/j.nut.2020.111068. Epub 2020 Nov 26.
The aim of this study was to investigate the predictive value of bioimpedance phase angle (PA) on selected clinical outcomes in patients hospitalized in internal-medicine wards.
This was a retrospective observational study of 168 patients admitted to the internalmedicine service (52.9% women, 47.1% men), with a mean (± SD) age of 73.9 ± 15.9 y. Anthropometric examination, laboratory tests, and bioelectrical impedance analysis were performed. Bioimpedance-derived PA was the study's parameter. Length of hospital stay, prospective all-cause hospital readmission, mortality, and falls were the clinical endpoints.
Across the four PA quartile groups, age was incrementally higher (P ≤ 0.001). Multivariate linear regression models showed that PA quartile 1 was significantly associated with length of hospital stay (β, SE) in both crude and adjusted models-respectively, β (SE) = 6.199 (1.625), P ≤ 0.001, and β = 2.193 (1.355), P = 0.033. Over a 9-mo follow-up period, the hazard ratios for readmission, in-hospital falls, and mortality were associated with the lowest phase angle (PA quartile 1 versus quartiles 2-4)-respectively, 2.07 (95% confidence interval [CI], 1.28-3.35), 2.36 (95% CI, 1.05-5.33), and 2.85 (95% CI, 1.01-7.39). Associations between narrow PA and outcomes continued to be significant after adjustments for various confounders.
In internal-medicine wards, bioimpedance-derived PA emerged as a predictor of length of hospital stay, hospital readmission, falls, and mortality. The present findings suggest that in the hospital setting, PA assessment could be useful in identifying patients at higher risk who need specific nutritional support.
本研究旨在探讨生物阻抗相位角(PA)对内科住院患者某些临床结局的预测价值。
这是一项回顾性观察性研究,共纳入 168 名入住内科病房的患者(女性占 52.9%,男性占 47.1%),平均年龄(±标准差)为 73.9±15.9 岁。进行人体测量检查、实验室检查和生物电阻抗分析。生物阻抗衍生的 PA 是本研究的参数。住院时间、预期全因院内再入院、死亡率和跌倒为临床终点。
在四个 PA 四分位组中,年龄逐渐升高(P≤0.001)。多变量线性回归模型显示,PA 四分位 1 在未调整和调整模型中均与住院时间显著相关-分别为β(SE)=6.199(1.625),P≤0.001,和β=2.193(1.355),P=0.033。在 9 个月的随访期间,再入院、院内跌倒和死亡率的风险比与最低相位角(PA 四分位 1 与四分位 2-4)相关-分别为 2.07(95%置信区间[CI],1.28-3.35),2.36(95%CI,1.05-5.33)和 2.85(95%CI,1.01-7.39)。在调整了各种混杂因素后,窄 PA 与结局之间的关联仍然显著。
在内科病房中,生物阻抗衍生的 PA 可作为住院时间、院内再入院、跌倒和死亡率的预测指标。本研究结果表明,在医院环境中,PA 评估可能有助于识别需要特定营养支持的高风险患者。