Monitoring of nutritional status in patients with pressure injuries using the phase angle as an indicator – a study of two cases

Introduction:
Bioelectrical impedance (BIA) is one of the most widely used indirect methods for assessing human body composition. The phase angle (PhA) as its derivative is considered an indicator of cellular health and monitoring of nutritional status. Due to its safety and reproducibility, it can be used as a prognostic indicator in disease, the assessment of mortality risk, and the effectiveness of nutritional interventions, as reflected in an increasing number of scientific studies. The aim of the study was to assess nutritional status using the PhA indicator in the course of treatment in two patients with pressure injuries.

Material and methods:
Two patients with pressure injuries were selected to have three consecutive BIA tests, from which the PhA indicator was calculated. In the subsequent three measurements, it was assessed, correlating this with the local wound condition on the day of the measurements taken.

Results:
After the initial assessment, nutritional intervention was implemented simultaneously with medical and nursing interventions resulting from the wound care plan, observing a systematic increase in PhA parameters starting from the values: Patient I – 3.2; Patient II – 3.3 during the first examination. Subsequently, after 4 and 16 months in the final measurements, the PhA was 5.3° in Patient I and 4.5° in Patient II, which equated to full wound healing, as well as a significant improvement in the nutritional status of the patients compared to the baseline prior to implementing professional care.

Conclusions:
The assessment of nutritional status should be one of the pillars of a comprehensive examination of a patient with a chronic wound, while also being a determinant of the recovery process. In the cases presented, the correlation between wound condition and the importance played by the PhA can be seen without any doubt. Its increase influences and enhances the regenerative processes within the wound as well as the patient’s overall pro-health status. Further studies with a larger group of patients are needed to demonstrate and confirm the multifaceted impact of the use of the above-mentioned indicator in the treatment of chronic wounds.