Papanastasiou Pantelis, Chaloulakou Stavroula, Karayiannis Dimitrios, Almperti Avra, Poupouzas Georgios, Vrettou Charikleia S, Issaris Vasileios, Jahaj Edison, Vassiliou Alice G, Dimopoulou Ioanna
Department of Clinical Nutrition, Evangelismos General Hospital, 10676 Athens, Greece.
Pulmonary Department, Evangelismos General Hospital, 10676 Athens, Greece.
Healthcare (Basel). 2025 Jun 18;13(12):1463. doi: 10.3390/healthcare13121463.
BACKGROUND/OBJECTIVES: The phase angle (PhA) is an emerging biomarker reflecting the cellular integrity and nutritional status. This study aimed to explore potential associations between the PhA, clinical severity scores, and 60-day survival outcomes following an admission to the Intensive Care Unit (ICU).
This prospective, single-center study included 43 critically ill patients admitted to the ICU at Evangelismos General Hospital between May and November 2024. Patients were stratified by their PhA (≤5.4° vs. >5.4°). The PhA was measured at admission and subsequently on days 5-7, 10-11, 13-14, and until discharge. Severity scores (SOFA and APACHE II) were recorded. Between-group differences were assessed using independent samples -tests and Mann-Whitney U tests, as appropriate. Survival was analyzed using Kaplan-Meier curves and Cox proportional hazards models.
The mean age was 54.6 ± 17 years; 63.6% were male. At ICU admission, patients with a PhA > 5.4° were significantly younger ( < 0.001) and had a higher fat-free mass ( < 0.001), greater calf circumference ( < 0.001), higher extracellular water ( < 0.001), larger mid-upper arm circumference ( = 0.009), and higher resting energy expenditure per kilogram (27.4 vs. 23.1 kcal/kg, = 0.002). The PhA declined significantly during the ICU stay ( < 0.001). The Kaplan-Meier analysis showed a significantly shorter survival in patients with a PhA ≤ 5.4° (HR: 6.32, = 0.019), which remained significant after adjusting for sepsis ( = 0.017). In a multivariable Cox regression, both PhA and APACHE II scores independently predicted mortality.
While limited by a small sample size and single-center design, these findings support the further exploration of the PhA as a monitoring tool in critical care.
背景/目的：相角（PhA）是一种新兴的生物标志物，可反映细胞完整性和营养状况。本研究旨在探讨重症监护病房（ICU）收治后相角、临床严重程度评分与60天生存结局之间的潜在关联。
这项前瞻性单中心研究纳入了2024年5月至11月期间在福音总医院ICU收治的43例危重症患者。患者按相角分层（≤5.4°与>5.4°）。在入院时以及随后的第5 - 7天、10 - 11天、13 - 14天直至出院时测量相角。记录严重程度评分（序贯器官衰竭评估（SOFA）和急性生理与慢性健康状况评分系统II（APACHE II））。根据情况使用独立样本t检验和曼 - 惠特尼U检验评估组间差异。使用Kaplan - Meier曲线和Cox比例风险模型分析生存情况。
平均年龄为54.6±17岁；63.6%为男性。在ICU入院时，相角>5.4°的患者明显更年轻（P<0.001），且无脂肪量更高（P<0.001）、小腿围更大（P<0.001）、细胞外液更高（P<0.001）、上臂中部周长更大（P = 0.009）以及每千克静息能量消耗更高（27.4对23.1千卡/千克，P = 0.002）。在ICU住院期间相角显著下降（P<0.001）。Kaplan - Meier分析显示，相角≤5.4°的患者生存时间显著缩短（风险比：6.32，P = 0.019），在调整脓毒症因素后仍具有显著性（P = 0.017）。在多变量Cox回归分析中，相角和APACHE II评分均独立预测死亡率。
尽管受样本量小和单中心设计的限制，但这些发现支持进一步探索将相角作为危重症监护中的一种监测工具。
