Wang Yao, Liu Tingting, Zheng Tianru, Zhang Yun, Li Li, Gao Maolong
Elderly Demonstration Ward, Beijing Geriatric Hospital, Beijing, China.
Beijing lnstitute of Integrative Medicine Geriatrics, Beijing Geriatric Hospital, Beijing, China.
PeerJ. 2024 Nov 26;12:e18592. doi: 10.7717/peerj.18592. eCollection 2024.
We aimed to investigate the value of phase angle (PhA) as a prognostic marker for mortality in elderly patients with multimorbidity using a matched case-control study.
This study was conducted with patients 70 years of age or older with multimorbidity at Beijing Geriatric Hospital. The body composition parameters including PhA were determined using bioelectrical impedance analysis. Common hematological indices were determined using blood tests. The outcome was mortality 1 year after admission. A multivariate logistic regression analysis was employed to identify independent risk factors for death. A receiver-operating characteristic (ROC) curve analysis was used to evaluate the performance of risk factors in predicting death.
A total of 30 deceased patients were included in the death group. The living patients were matched 1:1 with the deceased patients in age, gender, and Cumulative Illness Rating Scale-Geriatric score to generate a survival group of 30. The death group exhibited higher levels of blood urea nitrogen and extracellular water to total body water ratio and lower levels of PhA and prealbumin than the survival group. The multivariate logistic regression analysis identified PhA as the only independent risk factor for mortality (OR = 3.296, 95% CI [1.201-9.044], < 0.05). For the ROC curve analysis, PhA had an area of 0.854 (95% CI [0.755-0.955], = 000). The Youden index was 0.700, and the optimal cutoff value associated with the Youden index was 2.45°.
PhA serves as a good prognostic marker for mortality in elderly patients with multimorbidity.
我们旨在通过一项匹配病例对照研究，探讨相位角（PhA）作为老年多病患者死亡率预后标志物的价值。
本研究在北京老年医院对70岁及以上的多病患者进行。使用生物电阻抗分析测定包括PhA在内的身体成分参数。通过血液检测测定常见血液学指标。结局为入院1年后的死亡率。采用多因素逻辑回归分析确定死亡的独立危险因素。使用受试者工作特征（ROC）曲线分析评估危险因素预测死亡的性能。
死亡组共纳入30例死亡患者。存活患者在年龄、性别和累积疾病评分量表-老年版评分方面与死亡患者1:1匹配，形成一个30人的存活组。与存活组相比，死亡组的血尿素氮水平和细胞外水与总体水比率更高，而PhA和前白蛋白水平更低。多因素逻辑回归分析确定PhA是死亡率的唯一独立危险因素（OR = 3.296，95%CI[1.201 - 9.044]，<0.05）。对于ROC曲线分析，PhA的曲线下面积为0.854（95%CI[0.755 - 0.955]，P = 0.000）。约登指数为0.700，与约登指数相关的最佳截断值为2.45°。
PhA可作为老年多病患者死亡率的良好预后标志物。
