Malnutrition assessed through phase angle and its relation to prognosis in patients with compensated liver cirrhosis: A prospective cohort study

• Published in: Digestive and liver disease Vol. 47; no. 4; pp. 309 - 314
• Main Authors: Ruiz-Margáin, Astrid, Macías-Rodríguez, Ricardo U, Duarte-Rojo, Andrés, Ríos-Torres, Silvia L, Espinosa-Cuevas, Ángeles, Torre, Aldo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2015
• Subjects: Adolescent; Adult; Aged; Bioelectrical impedance; Electric Impedance; Female; Follow-Up Studies; Gastroenterology and Hepatology; Humans; Liver - physiopathology; Liver Cirrhosis - diagnosis; Liver Cirrhosis - etiology; Liver Cirrhosis - physiopathology; Liver disease; Male; Malnutrition - complications; Malnutrition - diagnosis; Malnutrition - mortality; Mexico - epidemiology; Middle Aged; Mortality; Nutrition Assessment; Nutritional Status; Prognosis; Prospective Studies; Survival Rate - trends; Time Factors; Young Adult; Mexico; Mortality; Nutritional status; Bioelectrical impedance; Liver disease
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2014.12.015

Abstract Background Malnutrition is a frequent complication of cirrhosis and it has been associated to more severe disease and development of complications. Phase angle is a bedside reliable tool for nutritional assessment based on conductivity properties of body tissues. Aim To evaluate the association between malnutrition assessed through phase angle and mortality in patients with liver cirrhosis. Methods We performed a prospective cohort study in a tertiary care centre; 249 patients were enrolled with 48 months of follow-up. Clinical, nutritional (malnutrition = phase angle ≤ 4.9°) and biochemical evaluations were performed. Student's t -test and χ2 method were used as appropriate. Kaplan–Meier curves and multivariate Cox regression were used to evaluate mortality. Results Mean follow-up was 33.5 months. Survival analysis showed higher mortality in the malnourished group compared to the well-nourished group ( p = 0.076), Kaplan–Meier curves were further stratified according to compensated and decompensated status showing higher mortality in compensated patients according to Child–Pugh ( p = 0.002) and Model for End-Stage Liver Disease score ( p = 0.008) when malnutrition was present. Multivariate analysis showed that malnutrition was independently associated with mortality (HR = 2.15, 1.18–3.92). Conclusions In our cohort, malnutrition was independently associated with mortality. This is the first study showing higher mortality in malnourished compensated cirrhotic patients.