Bioelectrical impedance phase angle as a prognostic indicator in breast cancer

Gupta, Digant; Lammersfeld, C. A.; Vashi, Pankaj G.; King, Jessica; Dahlk, S.; Grutsch, James F.; Lis, Christopher G.

doi:10.1186/1471-2407-8-249

Cited by 214 publications

(211 citation statements)

References 39 publications

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“…This reveals that the phase angle, which is a valid nutritional marker and independent indicator of survival for patients receiving chemotherapy, 16,[18][19][20]31 was extremely low in this cohort. Within this cohort, we also investigated the validity of these nutritional markers as risk factors for outcomes after alloHCT and found that the pre-transplant phase angle is an independent predictor for 2-year overall survival, relapse mortality and progression-free survival (Urbain, unpublished data).…”

Section: Discussionmentioning

confidence: 95%

“…16 It is an established parameter for diagnosing malnutrition, and a useful prognostic marker in many clinical conditions 17 including several types of cancer. [18][19][20][21] The Subjective Global Assessment (SGA) questionnaire according to Detsky et al 22 is another means of demonstrating the best combination of sensitivity and specificity in identifying complications related to malnutrition, 23 making the SGA questionnaire a validated tool in cancer patients with which to evaluate nutritional status. 24 The main objective of this prospective study was to evaluate the nutritional status in patients before alloHCT and its course during the early post-transplant period until day þ 100 via weight change before admission, BMI normalized for gender and age, the SGA questionnaire, the phase angle normalized for gender, age, and BMI, and height-normalized fat-free mass and body fat mass.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Urbain

Birlinger

Lambert

et al. 2012

Bone Marrow Transplant

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There are few longitudinal data on nutritional status and body composition of patients undergoing allogeneic hematopoietic cell transplantation (alloHCT). We assessed nutritional status of 105 patients before alloHCT and its course during the early posttransplant period to day þ 30 and day þ 100 via weight history, body mass index (BMI) normalized for gender and age, Subjective Global Assessment, phase angle normalized for gender, age, and BMI, and fat-free and body fat masses. Furthermore, we present a multivariate regression model investigating the impact of factors on body weight. At admission, 23.8% reported significant weight losses (45%) in the previous 6 months, and we noted 31.5% with abnormal age-and sex-adjusted BMI values (p10th, X90th percentiles). BMI decreased significantly (Po0.0001) in both periods by 11% in total, meaning a weight loss of 8.6 ± 5.7 kg. Simultaneously, the patients experienced significant losses (Po0.0001) of both fat-free and body fat masses. Multivariate regression model revealed clinically relevant acute GVHD (parameter estimate 1.43; P ¼ 0.02) and moderate/severe anorexia (parameter estimate 1.07; P ¼ 0.058) as independent factors influencing early weight loss. In conclusion, our results show a significant deterioration in nutritional status during the early post-transplant period. Predominant alloHCT-associated complications such as anorexia and acute GVHD became evident as significant factors influencing nutritional status.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Urbain

Birlinger

Lambert

et al. 2012

Bone Marrow Transplant

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“…Gupta et al have shown that phase angle measurements in patients with breast, colon, and non-small-cell lung cancer act as prognostic indicators and that nutritional intervention targeted at improving phase angle could potentially improve survival in these patients. 6 Spence and Pomeranz demonstrated that electrical R of the epidermis increased in surgically induced wounds in an animal model and could be used as a valid measure of healing. 9 Wagner et al were able to use bioelectrical impedance as a discriminator in the development of pressure ulcers, confirmed by tissue biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…5 Lower phase angle measurements indicate a compromised metabolic state and are a predictor of negative outcomes. 6 The authors undertook an exploratory study to determine whether regional phase angle measurements serve as an indicator for the local metabolic status of chronic nonhealing wounds and reflected the status of the wound and to demonstrate that phase angle measurement is an accurate measure, not only of a patient's overall nutritional status, but also that of the wound itself. Positive findings would provide a rationale for a future study comparing regional phase angle measurement of the wound to a total body phase angle measurement in patients receiving JUVEN Ò nutritional supplementation, in order to provide a quantifiable measurement of the impact of the patient's nutritional supplementation in wound healing.…”

Section: Introductionmentioning

confidence: 99%

“…4,5,7 The measurement of phase angle has been effective in assessing cellular integrity and as an overall assessment of the metabolic status of patients with advanced-stage carcinomas. 6,8 Using bioelectrical impedance measurements, serial measurements were made to evaluate the status of chronic nonhealing wounds. The initial phase angle values reflected the overall integrity of cellular components in the chronic nonhealing wound.…”

Section: Introductionmentioning

confidence: 99%

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Phase Angle, an Alternative Physiological Tool to Assess Wound Treatment in Chronic Nonhealing Wounds

Moore¹,

Dobson²,

Castelllino³

et al. 2011

The Journal of the American College of Certified Wound Speciali

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BACKGROUND: This exploratory study was conducted in an effort to demonstrate that bioelectrical impedance analysis (BIA) phase angle measurement is a novel tool for monitoring the effectiveness of a wound care regimen at a regional level and is valuable in comparing that status with the overall metabolic health of the patient. Isolating and measuring the extent to which nutritional supplementation contributes to the healing process is difficult and confounded by the many treatment modalities patients undergo.OBJECTIVE: The authors conducted a limited exploratory study to determine whether regional phase angle measurements accurately reflected the status of chronic nonhealing wounds. This information would potentially provide the ability to quantitatively evaluate of the role of nutritional supplementation in wounds of varying etiologies by comparing regional BIA phase angle measurement with overall BIA phase angle measurement.METHODS: Eleven patients with wounds of varying etiologies were selected to participate. Each patient underwent a treatment regimen specific to his or her condition, and all patients were given JUVEN Ò nutritional supplement.RESULTS AND CONCLUSION: In all patients, the BIA phase angle measurement mirrored the health of the wound and provided an accurate tool for assessing the regional tissue health, a valuable insight in measuring the effectiveness of a systemic treatment.

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The prognostic value of standardized phase angle in adults with acute leukemia: A prospective study

et al. 2020

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Standardized phase angle (SPhA) is a tool used to estimate body composition and cell membrane integrity. Standardized phase angle has been shown to predict survival in solid malignancies and hematopoietic stem cell transplant patients. We investigated the predictive value of SPhA on 60‐day mortality, overall survival (OS), and length of hospital stay (LHS) for adults with acute myelogenous and lymphoblastic leukemia (AML and ALL). Consecutive patients ≥18 years with newly diagnosed acute leukemia receiving intensive chemotherapy were enrolled. Phase angle measurements were taken on day 1 of therapy for all patients and on the day of nadir marrow for AML patients. Measurements were standardized by BMI, gender, and age to calculate the SPhA. The difference between SPhA at nadir bone marrow compared to day 1 of induction was used to calculate change in SPhA. A cutoff of 25th percentile was used to dichotomize baseline SPhA. Among 100 patients, 88% were AML, 56% were female, and mean age was 59 years. Though not statistically significant, OS by Kaplan‐Meier analysis was shorter for those below the 25th percentile SPhA compared to those above (median OS: 11.0 months vs 19.5 months; P = .09). Lower baseline SPhA was associated with increased incidence of 60‐day mortality in univariable (odds ratio [OR] = 5.25; 1.35, 20.44; P = .02) but not multivariable analysis (OR = 3.12; 0.67, 14.48; P = .15) adjusted for age, creatinine, and cytogenetics. Increased change in SPhA was associated with worse OS (hazard ratio = 1.15; 1.00,1.33; P = .05) in multivariable analysis. Standardized phase angle is a rapid, noninvasive, and objective measure that may be used to inform risk stratification.

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Bioelectrical impedance phase angle as a prognostic indicator in breast cancer

Cited by 214 publications

References 39 publications

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Phase Angle, an Alternative Physiological Tool to Assess Wound Treatment in Chronic Nonhealing Wounds

The prognostic value of standardized phase angle in adults with acute leukemia: A prospective study

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