Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis.

ABSTRACT: AIM:To evaluate the prognostic value of the phase angle (PA) obtained from bioelectrical impedance analysis (BIA) for mortality prediction in patients with cirrhosis. METHODS:In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker (PA ? 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS:The patients were divided into two groups according to the PA cutoff value (PA > 4.9°, n = 73; PA ? 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin (IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ? 4.9° (P ? 0.05). Forty-eight (35.80%) patients died due to cirrhosis, with a median of 18 mo (interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one (64.60%) of these patients were from the PA ? 4.9° group. PA ? 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age (hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ? 4.9° were significantly more likely to die. CONCLUSION:In male patients with cirrhosis, the PA ? 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.

SUBMITTER: Belarmino G 

PROVIDER: S-EPMC5340995 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature