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Bioelectrical Impedance Phase Angle Changes During Hydration and Prognosis in Advanced Cancer

Harry R. Horvitz Center for Palliative Medicine, Division of Solid Tumor, Taussig Cancer Center, davism6{at}ccf.org

Tugba Yavuzsen, MD

Harry R. Horvitz Center for Palliative Medicine, Division of Solid Tumor, Taussig Cancer Center

Dilara Khoshknabi, MD

Harry R. Horvitz Center for Palliative Medicine, Division of Solid Tumor, Taussig Cancer Center

Jordanka Kirkova, MD

Harry R. Horvitz Center for Palliative Medicine, Division of Solid Tumor, Taussig Cancer Center

Declan Walsh, MSc, FACP, FRCP

Harry R. Horvitz Center for Palliative Medicine, Division of Solid Tumor, Taussig Cancer Center

Wael Lasheen, MD

Harry R. Horvitz Center for Palliative Medicine, Division of Solid Tumor, Taussig Cancer Center

Ruth Lagman, MD, MPH, FACP

Harry R. Horvitz Center for Palliative Medicine, Division of Solid Tumor, Taussig Cancer Center

Matthew T. Karafa, PhD

Department of Quantitative Health Sciences Cleveland Clinic, Cleveland, Ohio

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.

Key Words: dehydration • cachexia • bioelectrical impedance • phase angle

This version was published on June 1, 2009

American Journal of Hospice and Palliative Medicine®, Vol. 26, No. 3, 180-187 (2009)
DOI: 10.1177/1049909108330028


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