Association of phase angle with hospital-acquired functional decline in older patients undergoing cardiovascular surgery
Association of phase angle with hospital-acquired functional decline in older patients undergoing cardiovascular surgery
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DOI：
10.1016/j.nut.2021.111402
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发表时间：
2021-08-04
期刊：
影响因子：
4.4
通讯作者：
Daida, Hiroyuki
中科院分区：
文献类型：
--
作者：
Morisawa, Tomoyuki;Saitoh, Masakazu;Daida, Hiroyuki
目的：本研究的目的是检测通过生物电阻抗分析测量的术前相角(PHA)是否与接受心血管手术的老年患者的医院获得性功能下降有关。方法：这是一项前瞻性收集的数据的观察性研究，114名65岁的心血管疾病患者在2019年9月至2020年8月期间接受了择期心血管手术。根据PHA水平将患者分为三组。使用单变量和多变量分析，分析与医院获得性功能下降(术后不可能恢复到术前生理功能)相关的因素。结果：低PHA组的患者年龄显著高于中、高PHA组；以女性为主；纽约心脏协会心血管和EuroSCORE严重程度评分较高；体重指数、老年营养风险指数、血红蛋白和白蛋白水平显著较低。PHA与营养和身体机能呈显著正相关。所有患者医院获得性功能下降的发生率为26.3%，低PHA组患者的发生率明显更高。多变量分析显示，在所有模型中，PHA都被提取为医院获得性功能下降的一个因素。结论：PHA与接受心血管手术的老年患者的医院获得性功能下降有关。PHA可能是身体健康的综合指标，指示营养状况、身体功能和老年综合征(虚弱/骨质疏松症)，也是这组老年患者医院获得性功能下降的重要预测指标。(C)2021 Elsevier Inc.保留所有权利。
Objective: The aim of this study was to examine whether preoperative phase angle (PhA) measured by bioelectrical impedance analysis was associated with a hospital-acquired functional decline in older patients undergoing cardiovascular surgery. Methods: This was an observational study of prospectively collected data of 114 patients (>65 y of age) with cardiovascular disease who underwent elective cardiovascular surgery between September 2019 and August 2020. Patients were classified into tertiles based on PhA levels. Factors associated with the occurrence of hospital-acquired functional decline (postoperative recovery to preoperative physical function was not possible) were analyzed using univariate and multivariate analyses. Results: Patients in the low PhA group were significantly older than those in the middle and high PhA groups; were predominantly women; had higher New York Heart Association cardiovascular and EuroSCORE severity scores; and had significantly lower levels of body mass index, Geriatric Nutritional Risk Index, hemoglobin, and albumin. There was a significant correlation between PhA and nutrition and physical function. The incidence of hospital-acquired functional decline occurred in 26.3% of all patients, with a significantly higher incidence in patients in the low PhA group. Multivariate analysis showed that PhA was extracted as a factor for the hospital-acquired functional decline in all the models. Conclusions: PhA was associated with hospital-acquired functional decline in older patients undergoing cardiovascular surgery. PhA is likely to be a comprehensive indicator of physical health that indicates nutritional status, physical function, and geriatric syndrome (frailty/sarcopenia), and is an important predictor of hospital-acquired functional decline in this group of older patients. (c) 2021 Elsevier Inc. All rights reserved.