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

Renata Reis de Lima e Silva, Cláudia Porto Sabino Pinho, Isa Galvão Rodrigues, José Gildo de Moura Monteiro Júnior

The phase angle (PA) has been considered a sensitive tool to assess nutritional status and effectiveness of interventions dietetics. To evaluate the PA as an indicator of nutritional status and prognosis in critically ill patients. 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. 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). PA in the ICU may be useful to identify early and malnourished patients as a prognostic indicator.