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Phase Angle Is an Independent Predictor of 6‐Month Mortality in Patients With Decompensated Cirrhosis: A Prospective Cohort Study
Author(s) -
Saueressig Camila,
Glasenapp Joana Hoch,
Luft Vivian Cristine,
Alves Fernanda Donner,
Ferreira Pâmela Kremer,
Hammes Thais Ortiz,
Dall'Alba Valesca
Publication year - 2020
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10584
Subject(s) - medicine , bioelectrical impedance analysis , cirrhosis , prospective cohort study , cohort , malnutrition , risk of mortality , gastroenterology , proportional hazards model , cohort study , body mass index
Background This study aimed to evaluate the nutrition status through phase angle (PA) and its association with mortality in patients with decompensated cirrhosis. Methods A prospective cohort study was performed with hospitalized decompensated cirrhotic patients. Nutrition status was assessed by PA, bioelectrical impedance vector analysis (BIVA), and Subjective Global Assessment (SGA) within 72 hours of hospital admission. The best PA cutoff point for malnutrition diagnosis was determined by ROC curve analysis, considering the SGA as the reference standard. Predictors of 6‐month mortality were identified using Cox proportional hazards models, adjusted for Child‐Pugh and MELD scores, and hepatocellular carcinoma. Results This study included 97 patients, 63% male (n = 61), with a mean age of 60.1 ± 10.3 years. The median follow‐up time of patients was 11.2 months (IQR, 2.4–21). Overall mortality was 58.8% (n = 57) and 6‐month mortality was 35.1% (n = 34). Nutrition assessment according to BIVA indicated a risk for cachexia and normal hydration. Patients with values of PA ≤5.52° were considered malnourished. Malnourished patients according to PA (58.8%, n = 57) had a higher risk of 6‐month mortality (HR = 3.44; 95% CI, 1.51–7.84; P = .003), and each increase of 1° in PA values was associated with a reduction of 53% in 6‐month mortality risk. Conclusions The PA is an independent predictor of 6‐month mortality in patients with decompensated cirrhosis. Therefore, PA may be useful to assess the nutrition status and identify patients at the highest risk of mortality in clinical practice.