Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis

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Belarmino, Giliane ; Gonzalez, Maria Cristina ; Torrinhas, Raquel S. ; Sala, Priscila ; Andraus, Wellington ; Carneiro D'Albuquerque, Luiz Augusto ; Pereira, Rosa Maria R. ; Caparbo, Valeria F. ; Ravacci, Graziela R. ; Damiani, Lucas ; Heymsfield, Steven B. ; Waitzberg, Dan L.

• Document type: Journal article
• Source: WORLD JOURNAL OF HEPATOLOGY; v. 9, n. 7, p. 401-408, MAR 8 2017.
• Web of Science Citations: 27

Abstract

AIM To evaluate the prognostic value of the phase angle (PA) obtained from bioelectrical impedance analysis (BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker (PA <= 4.9 degrees) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value (PA > 4.9 degrees, n = 73; PA <= 4.9 degrees, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9 degrees were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin (IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs <= 4.9 degrees (P <= 0.05). Forty-eight (35.80%) patients died due to cirrhosis, with a median of 18 mo (interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one (64.60%) of these patients were from the PA <= 4.9 degrees group. PA <= 4.9 degrees significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age (hazard ratio = 2.05, 95% CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs <= 4.9 degrees were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA <= 4.9 degrees cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis. (AU)

• FAPESP's process: 12/15677-3 - Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model in cirrhotic patients
• Grantee: Giliane Belarmino
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 11/13243-3 - Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model in cirrhotic patients
• Grantee: Dan Linetzky Waitzberg
• Support Opportunities: Regular Research Grants