Bioelectrical impedance vector analysis, phase-angle assessment and relationship with malnutrition risk in a cohort of frail older hospital patients in the United Kingdom

Slee, Adrian; Birch, Deborah; Stokoe, David

doi:10.1016/j.nut.2014.06.002

Cited by 46 publications

(44 citation statements)

References 25 publications

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“…This cutoff coincided with the lowest tertile of PA (<4.5°). These values are in keeping with previous estimates showing that the mean PA in frail geriatric patients is ≈4.5° in women and 4.6° in men,29, 30 and that the optimal PA cutoff for detection of sarcopenia is 4.5° 17. By contrast, the mean PA in healthy geriatric patients has previously been reported as 6.2° in men and 5.6° in women.…”

Section: Discussionsupporting

confidence: 91%

“…Despite being more prevalent in malnourished patients, a low PA has been shown to have poor specificity for predicting malnutrition 36, 37. Previous studies showed only a borderline significant correlation between PA and Mini Nutritional Assessment Short Form score and no correlation with the Malnutrition Universal Screening Tool score 29. The low prevalence of malnutrition in our population (3% as defined by Mini Nutritional Assessment Short Form ≤7) and the short‐form screening tool used may have limited the power of this study to detect a significant association with PA.…”

Section: Discussioncontrasting

confidence: 62%

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Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study

Mullie

O’Brand

Bendayan

et al. 2018

JAHA

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BackgroundPhase angle (PA) is a bioimpedance measurement that is determined lean body mass and hydration status. Patients with low PA values are more likely to be frail, sarcopenic, or malnourished. Previous work has shown that low PA predicts adverse outcomes after cardiac surgery, but the effect of PA on survival has not previously been assessed in this setting.Methods and ResultsThe BICS (Bioimpedance in Cardiac Surgery) study recruited 277 patients undergoing major cardiac surgery at 2 university‐affiliated hospitals in Montreal, QC, Canada. Bioimpedance measurements as well as frailty and nutritional assessments were performed preoperatively. The primary outcome was all‐cause mortality. Secondary outcomes were 30‐day mortality, postoperative morbidity, and hospital length of stay. There were 10 deaths at 1 month of follow‐up and 16 deaths at 12 months of follow‐up. PA was associated with age, sex, body mass index, comorbidities, and frailty, as measured by the Short Physical Performance Battery and Fried scales. After adjusting for Society of Thoracic Surgeons–predicted mortality, lower PA was associated with higher mortality at 1 month (adjusted odds ratio, 3.57 per 1° decrease in PA; 95% confidence interval, 1.35–9.47) and at 12 months (adjusted odds ratio, 3.03 per 1° decrease in PA; 95% confidence interval, 1.30–7.09), a higher risk of overall morbidity (adjusted hazard ratio, 2.51 per 1° decrease in PA; 95% confidence interval, 1.32–4.75), and a longer hospital length of stay (adjusted β, 4.8 days per 1° decrease in PA; 95% confidence interval, 1.3–8.2 days).ConclusionsLow PA is associated with frailty and is predictive of mortality, morbidity, and length of stay after major cardiac surgery. Further work is needed to determine the responsiveness of PA to interventions aimed at reversing frailty.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 62%

Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study

Mullie

O’Brand

Bendayan

et al. 2018

JAHA

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“…In a recent study, Basile et al (60) reported independent effects of grip strength and skeletal muscle mass on phase angle measured in a cohort of elderly adults; low phase angle was associated with reduced grip strength. Slee et al (61) evaluated a cohort of frail older hospitalised patients, some of whom were malnourished, and observed a low phase angle compared with healthy elderly reference values (61) . Age-related changes in other BIA resistance and reactance ratios and combinations at different frequencies are also recognised.…”

Section: Bioimpedance Analysismentioning

confidence: 99%

Skeletal muscle mass and quality: evolution of modern measurement concepts in the context of sarcopenia

et al. 2015

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Conference on 'Nutrition and age-related muscle loss, sarcopenia and cachexia' The first reports of accurate skeletal muscle mass measurement in human subjects appeared at about the same time as introduction of the sarcopenia concept in the late 1980s. Since then these methods, computed tomography and MRI, have been used to gain insights into older (i.e. anthropometry and urinary markers) and more recently developed and refined methods (ultrasound, bioimpedance analysis and dual-energy X-ray absorptiometry) of quantifying regional and total body skeletal muscle mass. The objective of this review is to describe the evolution of these methods and their continued development in the context of sarcopenia evaluation and treatment. Advances in these technologies are described with a focus on additional quantifiable measures that relate to muscle composition and 'quality'. The integration of these collective evaluations with strength and physical performance indices is highlighted with linkages to evaluation of sarcopenia and the spectrum of related disorders such as sarcopenic obesity, cachexia and frailty. Our findings show that currently available methods and those in development are capable of non-invasively extending measures from solely 'mass' to quality evaluations that promise to close the gaps now recognised between skeletal muscle mass and muscle function, morbidity and mortality. As the largest tissue compartment in most adults, skeletal muscle mass and aspects of muscle composition can now be evaluated by a wide array of technologies that provide important new research and clinical opportunities aligned with the growing interest in the spectrum of conditions associated with sarcopenia.

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“…Therefore, the PhA has been proposed as a parameter to predict clinical outcomes and mortality for several diseases . In addition, several studies have considered it an important nutrition assessment tool . However, the usefulness of this parameter as a sarcopenia marker has not yet been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients

Santana¹,

Pinho²,

Silva

et al. 2018

Nut in Clin Prac

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Bioelectrical impedance vector analysis, phase-angle assessment and relationship with malnutrition risk in a cohort of frail older hospital patients in the United Kingdom

Cited by 46 publications

References 25 publications

Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study

Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study

Skeletal muscle mass and quality: evolution of modern measurement concepts in the context of sarcopenia

Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients

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