Phase Angle of Bioelectrical Impedance Analysis as Prognostic Factor in Palliative Care Patients at the National Cancer Institute in Mexico

Abstract

Patients with advanced cancer often experience symptoms of disease and treatment that contribute to distress such as weight loss, which is present in up to 85% of cancer patients. Palliative care in these patients focuses on care aimed at improving quality of life. Phase angle (PA) is obtained by bioelectric impedance analysis (BIA) and is associated with cellular function. It is considered a reliable marker of malnutrition. A low PA may suggest deterioration of the cell membrane, which in palliative patients may result in a short-term survival. The aim of this study was to associate PA and survival in palliative patients of the National Cancer Institute of Mexico. We included 452 patients (women, 56.4%); the average PA was 4.0°. The most frequent disease was gastric cancer (39.2%). Mean body mass index (BMI) was 22.84. The average survival of patients with PA ≤ 4° was 86 days, while in the group with PA > 4°, it was 163 days (P > 0.0001). PA showed significant positive correlation with survival time and BMI. Our results corroborate the reliability of PA in Mexican population, as an indicator of survival in palliative care patients compared to the reported literature in other countries.

Bioelectrical Impedance Phase Angle and Morbidity and Mortality in Critically Ill Children

“…The association between undernutrition and morbidity and mortality is known and widely documented in the adult population 7,25,26,34,[41][42][43][44][45] ; however, there is a lack of literature that demonstrates this association, evaluated particularly by body composition indicators, in sick and critically ill children. Thus, despite having several limitations, our study reinforces the importance of nutrition assessments in critically ill children and suggests that body composition may be useful not only for nutrition diagnosis and monitoring, but also for an additional indicator in estimating death risk and PICU LOS in this population.…”

Phase Angle and the Diagnosis of Impending Death in Patients with Advanced Cancer: Preliminary Findings

“…The multivariate HR was 0.85 (95% CI 0.72–0.99, p = .048) . A separate study in Mexico that included 628 palliative outpatients also identified phase angle ≤4° to be a significant prognostic marker (HR 1.9, 95% CI 1.6–2.4, p < .0001) .…”

“…Davis et al examined phase angle in 50 patients with advanced cancer from inpatient units with a median survival of approximately 2 months, and reported that a higher phase angle had a nonsignificant trend toward longer survival (univariate HR 0.81, 95% CI 0.66–1.01, p = .57; multivariate HR 0.79, 95% CI 0.61–1.01, p = .064) . In another study, Perez Camargo et al enrolled 452 patients hospitalized in a palliative care unit, and found that a phase angle of ≥4° was associated with longer survival (median 86 days vs. 163 days, p > .0001) . Because the BIA device used in this study required patients to be able to stand, patients with poor Karnofsky Performance Status ≤40% or delirium were excluded.…”

The Prognostic Role of Phase Angle in Advanced Cancer Patients: A Systematic Review

“…The selected papers were all published within the last 14 years, and most were performed on outpatients and conducted in the United States, Mexico, and South Korea . Five studies were prospective, and the others were retrospective . The age of the population included in the studies varied between the fifth and sixth decade of life.…”

“…One study was exclusively with colorectal cancer patients, 1 with pancreatic cancer patients, and 2 studies with lung cancer patients . For studies that included different cancer types, digestive tract cancer was the most common type (Table ).…”