Raw Bioelectrical Impedance Analysis Variables Are Independent Predictors of Early All-Cause Mortality in Patients With COPD

Blasio, Francesca de; Scalfi, Luca; Gregorio, Ada Di; Alicante, Paola; Bianco, Angelica; Tantucci, Claudio; Bellofiore, Barbara; Blasio, Francesco De

doi:10.1016/j.chest.2019.01.001

Cited by 34 publications

(40 citation statements)

References 43 publications

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“…Furthermore, the results are controversial. de Blasio et al, in a prospective cohort study with 210 stable COPD patients, demonstrated that low muscle mass, assessed by FFMI, was not an independent risk factor of mortality in 24 months (HR, 1.06; 95% CI, 0.64–1.75) 38 . Vestbo et al, by contrast, showed in a similar sample that low FFMI (below the 10th percentile) increased the risk of all‐cause mortality in 7 years by 1.5 times 39 .…”

Section: Discussionmentioning

confidence: 99%

Low Muscle Mass Is a Predictor of Malnutrition and Prolonged Hospital Stay in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Longitudinal Study

Teixeira¹,

Kowalski²,

Valduga

et al. 2020

J Parenter Enteral Nutr

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Background Malnutrition in chronic obstructive pulmonary disease (COPD) patients is more prevalent during times of exacerbation. Fat‐free mass index (FFMI), calf circumference (CC), and adductor muscle pollicis thickness (AMPT) can be used to identify reduced muscle mass and have been found to be good predictors of clinical outcomes in other conditions, but they have not been investigated in COPD. Therefore, this study evaluated low muscle mass as predictor of malnutrition, prolonged length of stay (LOS), and in‐hospital death in COPD patients. Methods This prospective cohort study was carried out in hospitalized patients with COPD exacerbation. Malnutrition diagnosis was performed by Subjective Global Assessment, and muscle mass was assessed by FFMI, calculated using fat‐free mass from bioelectrical impedance, CC, and AMPT. Clinical outcomes (LOS and in‐hospital death) were collected from records. Results One hundred seventy‐six patients were included (68.2 ± 10.4 years old, 56.2% women); 74.2% were classified as Global Initiative of Chronic Obstructive Lung Disease 2 or 3 and 58.2% as malnourished. The median LOS was 11 (7–19) days, and the incidence of death was 9.1%. Low FFMI and CC predicted malnutrition (low CC: odds ratio [OR], 4.6; 95% CI, 2.2–9.7 and low FFMI: OR, 8.8; 95% CI, 3.7–20.8) and were associated with prolonged LOS (low CC: OR, 2.3; 95% CI, 1.1–4.6 and low FFMI: OR, 2.5; 95% CI, 1.3–4.8). Conclusion Simple, inexpensive, and noninvasive parameters of muscle mass—FFMI and CC—are good predictors of malnutrition and prolonged LOS in COPD patients experiencing exacerbation.

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Section: Discussionmentioning

confidence: 99%

Low Muscle Mass Is a Predictor of Malnutrition and Prolonged Hospital Stay in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Longitudinal Study

Teixeira¹,

Kowalski²,

Valduga

et al. 2020

J Parenter Enteral Nutr

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“…The mean PhA found in our sample was 4.4 (3.2e5.4 ), showing a situation of inflammation and cell injury associated with SARS-CoV-2 infection. In literature, there are few data on PhA in acute respiratory pathology and infectious processes [35], usually described in chronic pathology (cancer, cirrhosis, chronic obstructive pulmonary disease (COPD)) [30,31]. Shah et al has described that the PhA in human immunodeficiency virus (HIV) subjects with acute coinfection by tuberculosis (TB) was 5.42 þ 1.01 in men and 5.35 þ 1.27 in women (539 HIV patients with and without TB coinfection) [38].…”

Section: Discussionmentioning

confidence: 99%

Phase angle and standardized phase angle from bioelectrical impedance measurements as a prognostic factor for mortality at 90 days in patients with COVID-19: A longitudinal cohort study

et al. 2022

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Background and aims Severe acute COVID-19 has taken on pandemic proportions with growing interest in identification of prognostic factors for mortality. Standardized bioelectrical impedance (BI) phase angle (SPhA), which is PhA adjusted by age and sex, has been related to mortality in patients with several diseases but never investigated in COVID-19. Inflammation, a consequence of COVID-19 infection, affects fluid status (hydration) and can be identified with PhA. The aim of this study was to determine the predictive role of PhA on 90 days survival of adults with COVID-19. Methods We studied 127 consecutive patients diagnosed with COVID-19. BI measurements determined with a 50 kHz phase-sensitive BI device, body composition parameters and laboratory markers were evaluated as predictors of mortality. Results Non-surviving COVID-19 patients had significantly lower PhA and SPhA values (p<0.001) and increased hydration (p<0.001) compared to surviving patients. Patients in the lowest SPhA quartile had increased (p<0.001) mortality and hospital stay, hyperhydration (p<0.001), increased inflammation biomarkers [CRP (p<0.001)], decreased nutritional parameters: body mass cell index [BCMI (p<0.001) albumin (p<0.001)], and reduced other biomarkers [D-dimer (p=0.002)]. Multivariate analysis (Cox regression) revealed that PhA and hydration status, adjusted for age, sex, BMI, diabetes, hypertension, dyslipidaemia or heart disease, were associated (p<0.001) with increased mortality. The hazard ratio was 2.48 (95% CI, 1.60-3.84, p<0.001) for PhA and 1.12 (95% CI, 1.04 –1.20, p=0.003) for hydration percentage. PhA <3.95° was the cut-off for predicting mortality in acute COVID-19 with 93.8% sensitivity and 66.7% specificity. PhA offers greater sensitivity as a predictive prognostic test at admission, compared to the established analytical parameters of poor prognosis (CRP, lymphocytes, prealbumin). Conclusions Low PhA (<3.95°), independent of age, sex, BMI, and comorbidities, is a significant predictor of mortality risk in COVID-19. These findings suggest that the evaluation of body composition with single-frequency phase-sensitive BI measurements should be included in the routine clinical assessment of COVID-19 patients at hospital admission to identify patients at increased mortality risk.

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“…), but also to the use of different diagnostic approaches. De Blasio et al, using the diagnostic criteria for malnutrition proposed by the 2016 ESPEN consensus, reported an average prevalence of 19.8% [115][116][117][118] that was higher in the more advanced stages of disease, as already reported in previous papers using other diagnostic approaches 119 . The prevalence of sarcopenia, referring to EWGSOP criteria is reported to vary between the 14.5 and 25% 120 .…”

Section: Copd-related Malnutrition and Sarcopeniamentioning

confidence: 55%

Elderly with COPD: comoborbitidies and systemic consequences

Mollica

Aronne

Paoli

et al. 2020

JGG

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Raw Bioelectrical Impedance Analysis Variables Are Independent Predictors of Early All-Cause Mortality in Patients With COPD

Cited by 34 publications

References 43 publications

Low Muscle Mass Is a Predictor of Malnutrition and Prolonged Hospital Stay in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Longitudinal Study

Low Muscle Mass Is a Predictor of Malnutrition and Prolonged Hospital Stay in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Longitudinal Study

Phase angle and standardized phase angle from bioelectrical impedance measurements as a prognostic factor for mortality at 90 days in patients with COVID-19: A longitudinal cohort study

Elderly with COPD: comoborbitidies and systemic consequences

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