4.7 Article

Phase Angle Is a Stronger Predictor of Hospital Outcome than Subjective Global Assessment-Results from the Prospective Dessau Hospital Malnutrition Study

Journal

NUTRIENTS
Volume 14, Issue 9, Pages -

Publisher

MDPI
DOI: 10.3390/nu14091780

Keywords

bioimpedance analysis; screening; nutritional status; inflammatory status; medical patients; surgical patients

Funding

  1. Fresenius Kabi Deutschland GmbH

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This prospective cohort study compared the performance of phase angle and subjective global assessment in predicting length of hospital stay and in-hospital mortality in patients at risk of malnutrition. The study found that phase angle was a stronger predictor than subjective global assessment.
This prospective cohort study of 16,943 consecutive patients compared phase angle (PhA, foot-to-hand at 50 kHz) and subjective global assessment (SGA) to predict outcomes length of hospital stay (LOS) and in-hospital mortality in patients at risk of malnutrition (NRS-2002 >= 3). In 1505 patients, the independent effects on LOS were determined by competing risk analysis and on mortality by logistic regression. In model I, including influence factors age, sex, BMI, and diagnoses, malnourished (SGA B and C) patients had a lower chance for a regular discharge (HR 0.74; 95%CI 0.69-0.79) and an increased risk of mortality (OR 2.87; 95%CI 1.38-5.94). The association of SGA and outcomes regular discharge and mortality was completely abrogated when PhA was added (model II). Low PhA reduced the chance of a regular discharge by 53% in patients with a PhA <= 3 degrees (HR 0.47; 95%CI 0.39-0.56) as compared to PhA > 5 degrees. Mortality was reduced by 56% for each 1 degrees of PhA (OR 0.44; 95%CI 0.32-0.61). Even when CRP was added in model III, PhA <= 3 degrees was associated with a 41% lower chance for a regular discharge (HR 0.59; 95%CI 0.48-0.72). In patients at risk of malnutrition, the objective measure PhA was a stronger predictor of LOS and mortality than SGA.

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