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ワカバヤシ ヒデタカ
WAKABAYASHI Hidetaka
若林 秀隆 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Optimal Cutoff Values of Site-Specific Phase Angle for Predicting Independence in Activities of Daily Living in Post-stroke Patients. |
| 掲載誌名 | 正式名：Annals of geriatric medicine and research 略 称：Ann Geriatr Med Res ISSNコード：25084909/25084798 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 29(3),pp.403-413 |
| 著者・共著者 | Yoshihiro Yoshimura, Hidetaka Wakabayashi, Fumihiko Nagano, Ayaka Matsumoto, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Takenori Hamada, Kouki Yoneda |
| 担当区分 | 2nd著者 |
| 発行年月 | 2025/09 |
| 概要 | BACKGROUND:Phase angle (PhA) is a potential indicator of nutritional status and functional outcomes. However, optimal regional PhA cutoff values for predicting activities of daily living (ADL) post-stroke are unclear. We aimed to determine these cutoffs and assess whether PhA adds prognostic value to established clinical models.METHODS:In this retrospective cohort study, stroke patients undergoing inpatient rehabilitation had body composition and PhA measured via multi-frequency bioelectrical impedance analysis. The primary outcome was ADL independence at discharge (motor Functional Independence Measure >78). Receiver operating characteristic (ROC) curves identified optimal PhA cutoffs; logistic regression assessed their predictive value, adjusting for confounders. Incremental discriminative ability was evaluated using area under the ROC curve (AUC) comparisons with DeLong's test.RESULTS:Among 1,080 patients (median age, 75.6 years; 54.1% men), optimal PhA cutoffs were: whole-body (women 3.90°, men 4.60°), non-paretic upper limb (4.45°, 4.90°), and non-paretic lower limb (4.00°, 4.80°). Higher PhA values above these cutoffs were independently associated with ADL independence (all p<0.05). Adding whole-body PhA to the baseline model improved AUC from 0.937 to 0.970 (ΔAUC=0.033; p=0.011); significant gains were observed for limb PhA.CONCLUSIONS:Optimal site-specific PhA cutoffs predict ADL independence at discharge in post-stroke patients. PhA provides significant incremental prognostic value beyond established clinical models, supporting its use in tailoring rehabilitation strategies. |
| DOI | 10.4235/agmr.25.0028 |
| PMID | 41025275 |