Background: Phase Angle (PhA) value measured by bioelectrical impedance analysis (BIA) could be considered a good marker of the patient’s cell mass and cellular damage. Various studies have shown that the value of PhA is associated with an increased nutritional risk in several pathologies. However, not many studies have focused on the use of PhA as a screening tool in admitted patients. The aim of this study is to evaluate the prognostic value of PhA to determine disease-related malnutrition (DRM) and the risk that this entails for mortality and length of stay (LOS). Methods: 570 patients admitted to the hospital for different causes were included in this retrospective observational study. Patients’ nutritional risk was assessed by screening tests such as the Malnutrition Universal Screening tool (MUST) and Subjective Global Assessment (SGA), in addition to non-invasive functional techniques, such as BIA and handgrip strength (HGS), 24–48 h after admission. After performing an SGA as the gold standard to assess malnutrition, PhA and SPhA values were used to determine DRM. Furthermore, both samples: malnutrition status (MS) and non-malnutrition status (NMS) were compared, with SphA-Malnutrition corresponding to a diagnosis of malnutrition. Statistical analysis of the sample was conducted with JAMOVI version 2.2.2. Results: Patients with MS had lower PhA and SPhA than patients with NMS (p < 0.001). The ROC curve analysis (AUC = 0.81) showed a cut-off point for MS for PhA = 5.4° (sensitivity 77.51% and specificity 74.07%) and AUC = 0.776 with a cut-off point for SPhA = −0.3 (sensitivity 81.74% and specificity 63.53%). Handgrip strength (HGS) was also observed to be a good predictor in hospitalized patients. Carrying out a comparative analysis between MS and NMS, length of stay (LOS) was 9.0 days in MS vs. 5.0 days in NMS patients (OR 1.07 (1.04–1.09, p < 0.001)). A low SPhA-malnutrition value (SPhA < −0.3) was significantly associated with a higher mortality hazards ratio (HR 7.87, 95% CI 2.56–24.24, p < 0.001). Conclusion: PhA, SPhA and HGS are shown to be good prognostic markers of DRM, LOS and mortality and could therefore be useful screening tools to complement the nutritional assessment of admitted patients.
Background: Patients with colorectal cancer (CRC) are largely malnourished, which decreases overall survival and treatment efficacy and increases mortality rates. We hypothesize that angle phase might be associated with the risk of sarcopenia as well as cancer complications in patients with CRC. The inclusion of various nutritional status indicators and clinical cancer outcomes can result in significant variability. Therefore, the objective of this study was to perform an exploratory analysis of nutritional evaluation tools used to assess body composition and muscle quality in patients with CRC, in order to predict cancer complications and survival rate. Methods: A total of 127 patients with CRC were included in this study. Bioelectrical impedance analysis and body composition were performed, which we used to obtain phase angle (PhA) values. Muscle function was assessed by hand-grip strength (HGS) and muscle quality and adipose tissue depot were performed using ultrasound techniques. Results: This study showed that there were significant differences in body composition between females and males, as well as in muscle quantity and quality. PhA was highly correlated with quadriceps rectus femoris of cross-sectional area (RF-CSA), circumference of quadriceps rectus femoris (RF-CIR), superficial subcutaneous abdominal fat (S-SAT), as well as HGS (p < 0.05). PhA was also correlated with water content in females, and with muscle mass and quality in males (p < 0.05). Specifically, we found that PhA was a good predictor for cancer complications in women and the risk of sarcopenia in men. In the linear model controlled for age and body mass index (BMI), high PhA value was associated with a decreased risk of complications in females (Odds Ratio (OR) = 0.15, 95% CI: 0.03–0.81, p < 0.05). High PhA value was associated with a decreased risk of sarcopenia in males (OR = 0.42, 95% CI: 0.19–0.95, p < 0.05). In addition, Receiving Operating Characteristics (ROC) curve analysis showed that PhA had a good diagnostic accuracy for detecting cancer complications in females (Area under curve (AUC) = 0.894, 95% CI: 0.88–0.89, p < 0.05) and the risk of sarcopenia in males (AUC = 0.959, 95% CI: 0.91–0.92, p < 0.05). Conclusions: PhA can accurately predict oncological complications in women and sarcopenia in men. These differences are relevant to understanding the nutritional status of patients with CRC and their personalized nutritional treatment.
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