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Bioelectrical impedance analysis values as markers to predict severity in critically ill patients
Yeon Hee Lee1, Jung-Dong Lee2, Dae Ryong Kang2
1Food Service and Clinical Nutrition Team, Ajou University Hospital, Worldcup-ro 164, Yeongtong-gu, Suwon 16499, Republic of Korea.
Journal of Critical Care
|April 6, 2017
Summary
Bioelectrical impedance analysis (BIA) parameters like phase angle (PhA), impedance, and reactance can predict mortality in critically ill patients. These BIA values demonstrated superior predictive power compared to traditional intensive care unit severity scoring systems.
Area of Science:
- Critical Care Medicine
- Biomedical Engineering
- Physiology
Background:
- Critically ill patients often exhibit altered body composition and fluid status.
- Accurate assessment of prognosis is crucial for effective management in intensive care units (ICUs).
- Traditional severity scoring systems may not fully capture the nuances of physiological changes in critical illness.
Purpose of the Study:
- To investigate bioelectrical impedance analysis (BIA)-derived parameters in critically ill patients.
- To evaluate differences in BIA parameters between survivors and nonsurvivors.
- To compare the predictive power of BIA parameters against established ICU severity scoring systems for mortality.
Main Methods:
- 241 critically ill surgical patients (mean age 62.9 years) were analyzed.
- Severity scores were calculated using APACHE II, SOFA, and SAPS III.
- Body composition was assessed using a portable segmental BIA device.
Main Results:
- Impedance, reactance, and phase angle (PhA) were statistically significant predictors of mortality (P<0.001).
- BIA parameters, particularly reactance and PhA, showed significantly better discrimination than all three severity scoring systems (AUC comparison).
- Receiver operating characteristic curve analysis indicated that BIA values (impedance, reactance, PhA) had higher AUC values than severity scoring.
Conclusions:
- Phase angle (PhA), impedance, and reactance measured by BIA are associated with mortality outcomes in critically ill patients.
- BIA-derived parameters demonstrated stronger predictive power for mortality than commonly used ICU severity scoring systems.
- BIA offers a valuable, non-invasive tool for prognostication in the intensive care setting.