Zheng Wen-He, Zhao Yi-He, Yao Yan, Huang Hui-Bin
Department of Critical Care Medicine, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Front Med (Lausanne). 2023 Jan 9;9:1059747. doi: 10.3389/fmed.2022.1059747. eCollection 2022.
Bioelectrical impedance-derived phase angle (PA) has exhibited good prognostic values in several non-critical illnesses. However, its predictive value for critically ill patients remains unclear. Thus, we aimed to perform a systematic review and meta-analysis to investigate the relationship between PA and survival in such a patient population.
We searched for relevant studies in PubMed, Embase, and the Cochrane database up to Jan 20, 2022. Meta-analyses were performed to determine the association between the baseline PA after admission with survival. We further conducted subgroup analyses and sensitivity analyses to explore the sources of heterogeneity.
We included 20 studies with 3,770 patients. Patients with low PA were associated with a significantly higher mortality risk than those with normal PA (OR 2.45, 95% CI 1.97-3.05, < 0.00001). Compared to survivors, non-survivors had lower PA values (MD 0.82°, 95% CI 0.66-0.98; < 0.00001). Similar results were also found when pooling studies reported regression analyses of PA as continuous (OR = 0.64; 95% CI 0.52-0.79, < 0.00001) or categorical variable (OR = 2.42; 95% CI 1.76-3.34; < 0.00001). These results were further confirmed in subgroup analyses and sensitivity analyses.
Our results indicated that PA may be an important prognostic factor of survival in critically ill patients and can nicely complement the deficiencies of other severity scoring systems in the ICU setting.
生物电阻抗衍生的相位角(PA)在几种非危重病中已显示出良好的预后价值。然而,其对危重症患者的预测价值仍不明确。因此,我们旨在进行一项系统评价和荟萃分析,以研究此类患者群体中PA与生存之间的关系。
我们在PubMed、Embase和Cochrane数据库中检索截至2022年1月20日的相关研究。进行荟萃分析以确定入院后基线PA与生存之间的关联。我们进一步进行亚组分析和敏感性分析以探索异质性来源。
我们纳入了20项研究,共3770例患者。低PA患者的死亡风险显著高于正常PA患者(OR 2.45,95%CI 1.97 - 3.05,P<0.00001)。与幸存者相比,非幸存者的PA值较低(MD 0.82°,95%CI 0.66 - 0.98;P<0.00001)。当汇总将PA作为连续变量(OR = 0.64;95%CI 0.52 - 0.79,P<0.00001)或分类变量(OR = 2.42;95%CI 1.76 - 3.34;P<0.00001)进行回归分析的研究时,也发现了类似结果。这些结果在亚组分析和敏感性分析中得到进一步证实。
我们的结果表明,PA可能是危重症患者生存的重要预后因素,并且可以很好地补充ICU环境中其他严重程度评分系统的不足。