Malnutrition assessed by phase angle determines outcomes in low-risk cardiac surgery patients

Ringaitienė, Donata; Gineityte, D.; Vicka, Vaidas; Žvirblis, Tadas; Norkienė, Ieva; Šipylaitė, Jūratė; Irnius, Algimantas; Ivaškevičius, Juozas

doi:10.1016/j.clnu.2016.02.010

Cited by 43 publications

(38 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Low PA was predictive of resource use, as evidenced by a higher likelihood of prolonged LOS, discharge to specialized facilities, and need for readmission. Consistent with previous studies, low PA was predictive of postoperative morbidity 21, 22. Notably, PA provided similar predictive value when compared with the STS risk score, provided incremental predictive value when added to it, and remained independently predictive in sensitivity analyses adjusting for 15 known predictors of mortality after cardiac surgery.…”

Section: Discussionsupporting

confidence: 86%

“…Two previous single‐center studies21, 22 have shown that PA is a predictor of postoperative morbidity and prolonged LOS in patients undergoing cardiac surgery. However, one of these studies was limited only to low‐risk patients, and neither reported mortality as an outcome.…”

Section: Introductionmentioning

confidence: 95%

“…A decrease in muscle mass or an increase in ECW both tend to decrease PA. In cardiac patients, low PA is associated with low muscle mass and handgrip strength 21, 22. In the setting of heart failure, low PA is associated with increased mortality23, 24, 25 and prolonged length of stay (LOS) 26.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Mullie

O’Brand

Bendayan

et al. 2018

JAHA

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

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

Mullie

O’Brand

Bendayan

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…This step allowed the physiological changes of the body composition occurring in women and elderly patients, which result in lower but not pathological values of the PA, to be accounted for. The low PA margin was set at the 15th percentile of the mean population reference values, generating two groups of patients: malnourished and wellnourished (30). The age and gender adjusted cut-off values of the PA are presented in the Figure.…”

Section: Methodsmentioning

confidence: 99%

Preoperative risk factors of malnutrition for cardiac surgery patients

Ringaitienė

Gineityte

Vicka

et al. 2016

AML

Self Cite

View full text Add to dashboard Cite

Background.Malnutrition (MN) is prevalent in cardiac surgery, but there are no specific preoperative risk factors of MN. The aim of this study is to assess the clinically relevant risk factors of MN for cardiac surgery patients.Materials and methods.The nutritional state of the patients was evaluated one day prior to surgery using a bioelectrical impedance analysis phase angle (PA). Two groups of patients were generated according to low PA: malnourished and well nourished. Risk factors of MN were divided into three clinically relevant groups: psychosocial and lifestyle factors, laboratory findings and disease-associated factors. Variables in each different group were entered into separate multivariate logistic regression models.Results.A total of 712 patients were included in the study. The majority of them were 65-year old men after a CABG procedure. Low PA was present in 22.9% (163) of patients. The analysis of disease-related factors of MN revealed the importance of heart functions (NYHA IV class OR: 3.073, CI95%: 1.416–6.668, p = 0.007), valve pathology (OR: 1.825, CI95%: 1.182–2.819, p = 0.007), renal insufficiency (OR: 4.091, CI95%: 1.995–8.389, p < 0.001) and body mass index (OR: 0.928, CI95%: 0.890–0.968, p < 0.001). Laboratory values related to MN were levels of haemoglobin (OR: 0.967, CI95%: 0.951–0.983, p < 0.001) and C-reactive protein (OR: 1.015, CI95%: 1.002–1.028, p = 0.0279). The lifestyle variables that qualified as risk factors concerned the intake of food (OR: 3.030, CI95%: 1.353–6.757, p = 0.007) and mobility (OR: 2.770, CI95%: 1.067–7.194, p = 0.036).Conclusions.MN risk factors comprise three different clinical groups: psychosocial and lifestyle factors, laboratory findings and disease-associated factors. The patients who are most likely to be malnourished are those with valve pathology, severe imparted heart function, insufficient renal function and high inflammatory markers. Also these patients have decreased mobility and food intake.

show abstract

“…Á³îåëåêòðè÷íèé îï³ð ìîaeå âèêîðèñòîâóâàòèñü äëÿ îö³íêè ñêëàäó òêàíèí ò³ëà ³, ïåðåâàaeíî, áåçaeèðîâî¿ ìàñè ò³ëà КЛІНІЧНІ РЕКОМЕНДАЦІЇ / НАСТАНОВИ ó ñòàá³ëüíîãî ïàö³ºíòà, ùî íå ñòðàaeäàº íà ïîðóøåííÿ ð³äèííèõ êîìïàðòìåíò³â [34]. Ó ðÿä³ äîñë³äaeåíü îïèñàí³ ïåðåâàãè á³î³ìïåäàíñó [35][36][37][38] ³ ïåðåâàaeíî ôàçîâîãî êóòà [39] â îö³íö³ ïðîãíîçó äëÿ òÿaeêîõâîðèõ ïàö³ºíò³â. Ïðîòå éîãî çàñòîñóâàííÿ íå º ïîøèðåíîþ ïðàêòèêîþ.…”

Section: ïðèì³òêàunclassified

Методичні Рекомендації ESPEN Щодо Клінічного Харчування У Відділенні Інтенсивної Терапії

Singer¹,

Blaser²,

Berger³

et al. 2019

Pain Anaesth Int Care

View full text Add to dashboard Cite

Malnutrition assessed by phase angle determines outcomes in low-risk cardiac surgery patients

Cited by 43 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

Preoperative risk factors of malnutrition for cardiac surgery patients

Методичні Рекомендації ESPEN Щодо Клінічного Харчування У Відділенні Інтенсивної Терапії

Contact Info

Product

Resources

About