Phase angle as an indicator of nutritional status and prognosis in critically ill patients

: Introduccion: El angulo de fase (AF) viene siendo considerado una herramienta sensible para evaluar el estado nutricional y la efectividad de las intervenciones dietoterapicas. Objetivo: Evaluar el AF como indicador del estado nutricional y pronostico en pacientes criticos. Metodos: Estudio prospectivo observacional con pacientes admitidos en Unidades de Cuidado Intensivo Coronarias, entre Mayo y Octubre de 2013. El AF se determino por medio del analisis por Bioimpedancia Electrica, considerandose bajo AF valores inferiores a 5o para los hombres y 4,6o para las mujeres. Los valores obtenidos se relacionaron con otros parametros de evaluacion del estado nutricional: antropometricos (circunferencia del brazo – CB, pliegue cutaneo triciptal – PCT, area muscular del brazo corregida - AMBc circunferencia de pantorrilla – CP) y bioquimico (recuento total de linfocitos, hemoglobina, hematocrito), ademas de los pronosticos clinicos APACHE II (Acute Physiology and Chronic Health Disease Classification System II) y albumina serica. La tabulacion y analisis de los datos se realizaron a traves del paquete estadistico SPSS version 13.0. Resultados: La muestra se compuso por 110 pacientes, en la cual se verifico asociacion entre bajo AF e insuficiencia renal en dialisis (p. OBJECTIVE: To evaluate the PA as an indicator of nutritional status and prognosis in critically ill patients. METHODS: Prospective observational study of patients admitted to the Coronary Intensive Care Unit between May and October 2013. The PA was determined by bioelectrical impedance analysis, PA was considered low below 5o values for men and 4.6o for women. The values obtained were related to other evaluation parameters of nutritional status: anthropometric (arm circumference - AC , triceps skinfold thickness - TST , corrected arm muscle area - AMAc and calf circumference - CC) and biochemical (total lymphocyte count, hemoglobin, hematocrit), in addition to clinical prognostic APACHE II (Acute Physiology and Chronic Health Disease Classification System II) and serum albumin. The tabulation and analysis were performed using SPSS version 13.0. RESULTS: The sample consisted of 110 patients, in which an association was found between low AF and renal failure on dialysis (p < 0.001), % adequacy AC (p = 0.028), % adequacy of TST (p = 0.043), albumin level (p = 0.042), anemia (p = 0.040) and APACHE II (p = 0.012) scores. The AF was positively correlated with CC (p= 0.043) and inversely with the length of hospitalization (p = 0.006). CONCLUSIONS: PA in the ICU may be useful to identify early and malnourished patients as a prognostic indicator.