Observational studyIntensive care medicine2016
Fat-free mass at admission predicts 28-day mortality in intensive care unit patients: the international prospective observational study Phase Angle Project.
Observational study in Intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 49 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Phase angle project
Body Composition and Clinical Outcomes in Critically Ill Patients: A Prospective Observational Study
Bioelectrical Impedance Vector Analysis (BIVA) in Monitoring Hyperhydration and Polyneuromyopathy in Critically Ill Patients
Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 143 citations in OpenAlex.
- Diagnostic and application guidelines for malnutrition in adult patients (2025 edition).Asia Pacific journal of clinical nutrition · 2025Guideline
- Prognostic role of bioelectrical impedance phase angle for critically ill patients: A systemic review and meta-analysis.Frontiers in medicine · 2022Pooled it
- Phase angle and mortality: a systematic review.European journal of clinical nutrition · 2019Pooled it
- Fluid Shifts and Muscle Loss in Critical Care: Accuracy of Ultrasound Versus Bioelectrical Impedance Analysis.Nutrients · 2026Observational
- Assessment of hydrosodic balance by impedancemetry in intensive care: a monocentric prospective study, the EBaHIR study.Annals of medicine and surgery (2012) · 2026Article
- Practices, barriers, and opportunities for dietitians-nutrionists in critical care in Latin America: A cross-sectional study.JPEN. Journal of parenteral and enteral nutrition · 2026Article
- Protein nutrition in the ICU: a Delphi exercise to highlight knowledge and opinions of different professional groups involved in patient critical care.BMC nutrition · 2026Article
- Adiponectin and phase angle in the assessment of sarcopenia in Crohn's disease: beyond muscle mass.Frontiers in nutrition · 2026Article
- Advancing Nutritional Care Through Bioelectrical Impedance Analysis in Critical Patients.Nutrients · 2025Review
- Impact of in-hospital body mass index variation on 28-day mortality in critically ill surgical patients: a multi-center retrospective analysis.Frontiers in medicine · 2025Article
- Mortality Outcomes and Contributing Risk Factors in Patients with Hospital-Associated Disability.Journal of clinical medicine · 2024Article
- Skeletal muscle dysfunction with advancing age.Clinical science (London, England : 1979) · 2024Review
- Association of bioimpedance analysis parameters trajectories with clinical outcomes in neurocritical patients.Heliyon · 2024Article
- Bioelectrical Impedance in Premature Newborns and Its Relationship with Diet Therapy in a Neonatal Intensive Care Unit.Nutrients · 2024Article
- Bioimpedance-assessed muscle wasting and its relation to nutritional intake during the first week of ICU: a pre-planned secondary analysis of Nutriti Study.Annals of intensive care · 2024Article
- Assessment of quadriceps muscle mass by ultrasound in the postoperative period of cardiac surgery.The ultrasound journal · 2024Article
- Optimizing Nutrient Uptake in the Critically Ill: Insights into Malabsorption Management.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2024Article
- Association between phase angle and daily creatinine excretion changes in critically ill patients: an approach to muscle mass.Frontiers in physiology · 2024Article
- Comparison of Bioelectrical Impedance Analysis (BIA)-Derived Parameters in Healthy Volunteers and Critically Ill Patients.Life (Basel, Switzerland) · 2023Article
- Bioelectrical Impedance Analysis (BIA) for the Assessment of Body Composition in Oncology: A Scoping Review.Nutrients · 2023Article
Corrections and comments
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Authors and funding
15 authors at 11 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePhase angle as measured by bioelectrical impedance analysis reflects fat-free mass. Fat-free mass loss relates to worse prognosis in chronic diseases. Primary aim of this study was: to determine the association between fat-free mass at intensive care unit admission and 28-day mortality.
methodsTen centres in nine countries participated in this multicentre prospective observational study. The inclusion criteria were age >18 years; expected length of stay >48 h; absence of pacemaker, heart defibrillator implant, pregnancy and lactation. Fat-free mass was assessed by measurement of the 50-kHz phase angle at admission. The primary endpoint was 28-day mortality. The area under the receiver operating characteristic curve (AUC) was used to assess prediction of 28-day mortality by fat-free mass at ICU admission. The variables associated with 28-day mortality were analysed by means of multivariable logistic regression.
resultsOf the 3605 patients screened, 931 were analysed: age 61 ± 16 years, male 60 %, APACHE II 19 ± 9, body mass index 26 ± 6, day 1 phase angle 4.5° ± 1.9°. Day 1 phase angle was lower in patients who eventually died than in survivors (4.1° ± 2.0° vs. 4.6° ± 1.8°, P = 0.001). The day 1 phase angle AUC for 28-day mortality was 0.63 [0.58-0.67]. In multivariable analysis, the following were independently associated with 28-day mortality: age (adjusted odds ratio (aOR) 1.014 [95 % confidence interval 1.002-1.027], P = 0.03), day 1 phase angle (aOR 0.86 [0.78-0.96], P = 0.008), APACHE II (aOR 1.08 [1.06-1.11], P < 0.001), surgical patient (aOR 0.51 [0.33-0.79], P = 0.002), and admission for other diagnosis (aOR 0.39 [0.21-0.72], P = 0.003). A multivariable combined score improved the predictability of 28-day mortality: AUC = 0.79 [0.75-0.82].
conclusionLow fat-free mass at ICU admission is associated with 28-day mortality. A combined score improves mortality predictability.
trial registrationNCT01907347 ( http://www.clinicaltrials.gov ).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.