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Bioelectrical impedance phase angle changes during hydration and prognosis in advanced cancer
Mellar P Davis1, Tugba Yavuzsen, Dilara Khoshknabi
1Harry R. Horvitz Center for Palliative Medicine, Taussig Cancer Center, Cleveland Clinic, Ohio 44195, USA. davism6@ccf.org
Introduction:
We wished to determine bioelectrical impedance (BIA) correlates before hydration or changes during hydration and determine if these changes were prognostically important.
Methods And Materials:
Fifty eligible patients underwent BIA measurements 3 consecutive days. Laboratory studies (electrolytes, creatinine, and hemoglobin) on day 1; weights and vital signs were recorded. Kaplan-Meier survival estimates were made at 30 and 60 days. Hazard ratios (HRs) based on Cox proportional hazards model were calculated.
Results:
Weight loss was associated with shorter survival. A higher phase angle (PA) on day 1 predicted longer survival. Increased PA during hydration predicted shorter survival: increased weight during hydration predicted longer survival.
Discussion:
Higher phase angle before hydration predicts poorer survival and, paradoxically, an increase in phase angle during hydration predicted poorer survival and preexisting intracellular dehydration, cachexia, or poor membrane function.
Conclusions:
Phase angle and weight during hydration predict survival in cancer.
