Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, the Netherlands; Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
Clin Nutr. 2022 Jun;41(6):1256-1259. doi: 10.1016/j.clnu.2022.03.029. Epub 2022 Apr 6.
The use of severity of illness scoring systems, including the Acute Physiology and Chronic Health Evaluation (APACHE) III score, has made it possible to compare groups of patients and evaluate treatment strategies. Phase angle, derived from bio-impedance analysis, reflects tissue quality and quantity in which cell mass, membrane integrity and hydration state are represented. We hypothesized that phase angle on ICU admission may serve as a proxy for physical frailty and as such can be used as an additional predictor of long-term mortality after ICU admission.
A single-center prospective observational cohort study with consecutive patients, admitted to the ICU between June 2018 and June 2019. Demographic data, APACHE III, comorbidity, and phase angle in the first 6 h after ICU admission were collected and the ICU, hospital, and 1-year survival were registered.
Of all 1023 patients, 115 (11%) died within a year after ICU admission. Nonsurvivors had higher APACHE III scores than survivors [86 (65-119) vs. 55 (46-67), p < 0.001]. Phase angle was significantly higher in survivors than in nonsurvivors [5.4 (4.7-6.4) vs. 4.7 (3.9-6.0), p < 0.001]. Univariate analysis showed an association between mortality and admission type, sepsis, presence of malignancy, APACHE III, and PhA. Multivariate logistic regression analysis using these variables confirmed low PhA to be an independent predictor of 1-year mortality (OR: 1.81; CI: 1.09-2.97; p = 0.02), in addition to presence of malignancy (OR: 2.30; CI: 1.31-4.02; p = 0.004) and APACHE III score (OR: 1.03; CI: 1.02-1.04; p < 0.001).
In this single center study, low phase angle was independently associated with 1-year all-cause mortality after ICU admission.
gov number: NCT0444976.
严重程度评分系统的使用，包括急性生理学和慢性健康评估（APACHE）III 评分，使得比较患者群体和评估治疗策略成为可能。相位角源自生物阻抗分析，反映了组织质量和数量，其中细胞质量、膜完整性和水合状态都有体现。我们假设，入住 ICU 时的相位角可以作为身体脆弱的代表，并可以作为 ICU 入住后长期死亡率的额外预测指标。
这是一项单中心前瞻性观察队列研究，连续纳入 2018 年 6 月至 2019 年 6 月入住 ICU 的患者。收集患者的人口统计学数据、APACHE III、合并症以及入住 ICU 后 6 小时内的相位角，记录 ICU、医院和 1 年生存率。
在所有 1023 名患者中，有 115 名（11%）在 ICU 入住后 1 年内死亡。与幸存者相比，非幸存者的 APACHE III 评分更高[86（65-119）比 55（46-67），p<0.001]。幸存者的相位角显著高于非幸存者[5.4（4.7-6.4）比 4.7（3.9-6.0），p<0.001]。单因素分析显示，死亡率与入住类型、脓毒症、恶性肿瘤存在、APACHE III 和 PhA 有关。使用这些变量的多变量逻辑回归分析证实，低 PhA 是 1 年死亡率的独立预测因素（OR：1.81；95%CI：1.09-2.97；p=0.02），此外，恶性肿瘤存在（OR：2.30；95%CI：1.31-4.02；p=0.004）和 APACHE III 评分（OR：1.03；95%CI：1.02-1.04；p<0.001）也是独立预测因素。
在这项单中心研究中，入住 ICU 后低相位角与 1 年全因死亡率独立相关。
gov 注册号：NCT0444976。
