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nutrition

Sylvia Ryz, Larissa Nixdorf, Jürgen Puchinger, Andrea Lassnigg, Dominik Wiedemann, Martin H. Bernardi

11
Jun 16, 2022
Nutrients
DOI :
10.3390/nu14122491
Article
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Nutrients, Vol. 14, Pages 2491: Preoperative Phase Angle as a Risk Indicator in Cardiac Surgery—A Prospective Observational Study Nutrients doi: 10.3390/nu14122491 Authors: Sylvia Ryz Larissa Nixdorf Jürgen Puchinger Andrea Lassnigg Dominik Wiedemann Martin H. Bernardi
Background : The phase angle (PhA) can be used for prognostic assessments in critically ill patients. This study describes the perioperative course of PhA and associated risk indicators in a cohort of elective cardiac surgical patients.
Method : The PhA was measured in 168 patients once daily until postoperative day (POD) seven. Patients were split into two groups depending on their median preoperative PhA and analyzed for several clinical outcomes; logistic regression models were used.
Result : The PhA decreased from preoperative (6.1° ± 1.9°) to a nadir on POD 2 (3.5° ± 2.5°, mean difference -2.6° (95% CI, -3.0°; -2.1°; p < 0.0001)). Patients with lower preoperative PhA were older (71.0 ± 9.1 vs. 60.9 ± 12.0 years; p < 0.0001) and frailer (3.1 ± 1.3 vs. 2.3 ± 1.1; p < 0.0001), needed more fluids (8388 ± 3168 vs. 7417 ± 2459 mL, p = 0.0287), and stayed longer in the ICU (3.7 ± 4.5 vs. 2.6 ± 3.8 days, p = 0.0182). Preoperative PhA was independently influenced by frailty (OR 0.77; 95% CI 0.61; 0.98; p = 0.0344) and cardiac function (OR 1.85; 95%CI 1.07; 3.19; p = 0.028), whereas the postoperative PhA decline was independently influenced by higher fluid balances (OR 0.86; 95% CI 0.75; 0.99; p = 0.0371) and longer cardiopulmonary bypass times (OR 0.99; 95% CI 0.98; 0.99; p = 0.0344).
Conclusion : Perioperative PhA measurement is an easy to use bedside method that may critically influence risk evaluation for the outcome of cardiac surgery patients.

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