{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:13:34Z","timestamp":1792782814902,"version":"4.5.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008645","name":"Terumo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008645","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kobe University","id":[{"id":"https:\/\/ror.org\/03tgsfw79","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Anesth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Global Leadership Initiative on Malnutrition (GLIM) is an international nutritional assessment approach, but its evaluation for reduced muscle mass and inflammation criteria remain undefined in critically ill patients. We hypothesize that the phase angle derived from a bioelectrical impedance analysis (BIA) may be used as a GLIM inflammation criterion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>ICU patients expected to require\u2009\u2265\u200948\u00a0h of mechanical ventilation were stratified by the median phase angle. The primary outcomes were in-hospital mortality and the Barthel Index at discharge. Phase angle cut-off values were calculated for in-hospital death and the composite outcome of death or discharge with a Barthel Index\u2009&lt;\u200970. Outcomes were compared between groups using the BIA-based GLIM (phase angle and skeletal muscle index) and the GLIM assessed by C-reactive protein (CRP) and computed tomography (CT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-three patients were included. The phase angle was significantly associated with hospital stay and mechanical ventilation duration. The areas under the ROC curve of the phase angle for mortality and a Barthel Index\u2009&lt;\u200970 were higher than those for SOFA, APACHE II and maximum CRP. The BIA-based GLIM identified malnourished patients with significantly poorer prognoses than CRP\/CT-based GLIM. With phase angle thresholds of 2.67 and 4.03, the GLIM malnutrition showed a longer hospital stay, lower grip strength at discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The phase angle might be a suitable indicator for inflammation in the GLIM criteria, and appropriate BIA equipment providing both the phase angle and SMI might allow the initial assessment to be completed in a single step.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00540-026-03870-1","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:46:55Z","timestamp":1787150815000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Usefulness of the phase angle for inflammation criteria of the global leadership initiative on malnutrition in critically ill patients"],"prefix":"10.1007","author":[{"given":"Akane","family":"Kariya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Kanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Suganuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoka","family":"Miyagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Takaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-0294","authenticated-orcid":false,"given":"Kensuke","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"issue":"4","key":"3870_CR1","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1002\/jpen.2748","volume":"49","author":"CW Compher","year":"2025","unstructured":"Compher CW, Fukushima R, Correia MI, Gonzalez MC, McKeever L, Nakamura K, et al. Recognizing malnutrition in adults with critical illness: Guidance statements from the Global Leadership Initiative on Malnutrition. JPEN J Parenter Enteral Nutr. 2025;49(4):405\u201313. https:\/\/doi.org\/10.1002\/jpen.2748.","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"5","key":"3870_CR2","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1016\/j.clnu.2023.11.026","volume":"43","author":"T Cederholm","year":"2024","unstructured":"Cederholm T, Jensen GL, Ballesteros-Pomar MD, Blaauw R, Correia MI, Cuerda C, et al. Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach. Clin Nutr. 2024;43(5):1025\u201332. https:\/\/doi.org\/10.1016\/j.clnu.2023.11.026.","journal-title":"Clin Nutr"},{"issue":"3 Suppl","key":"3870_CR3","doi-asserted-by":"publisher","first-page":"397S","DOI":"10.1093\/ajcn\/64.3.397S","volume":"64","author":"HC Lukaski","year":"1996","unstructured":"Lukaski HC. Biological indexes considered in the derivation of the bioelectrical impedance analysis. Am J Clin Nutr. 1996;64(3 Suppl):397S-404S. https:\/\/doi.org\/10.1093\/ajcn\/64.3.397S.","journal-title":"Am J Clin Nutr"},{"issue":"12","key":"3870_CR4","doi-asserted-by":"publisher","first-page":"2801","DOI":"10.1016\/j.clnu.2022.10.010","volume":"41","author":"J Lima","year":"2022","unstructured":"Lima J, Eckert I, Gonzalez MC, Silva FM. Prognostic value of phase angle and bioelectrical impedance vector in critically ill patients: a systematic review and meta-analysis of observational studies. Clin Nutr. 2022;41(12):2801\u201316. https:\/\/doi.org\/10.1016\/j.clnu.2022.10.010.","journal-title":"Clin Nutr"},{"issue":"6","key":"3870_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/cc10546","volume":"15","author":"DK Heyland","year":"2011","unstructured":"Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care. 2011;15(6):R268. https:\/\/doi.org\/10.1186\/cc10546.","journal-title":"Crit Care"},{"issue":"5","key":"3870_CR6","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1093\/ajcn\/82.5.988","volume":"82","author":"GA Kaysen","year":"2005","unstructured":"Kaysen GA, Zhu F, Sarkar S, Heymsfield SB, Wong J, Kaitwatcharachai C, et al. Levin NW Estimation of total-body and limb muscle mass in hemodialysis patients by using multifrequency bioimpedance spectroscopy. Am J Clin Nutr. 2005;82(5):988\u201395.","journal-title":"Am J Clin Nutr"},{"issue":"4","key":"3870_CR7","doi-asserted-by":"publisher","DOI":"10.3390\/nu17040705","volume":"17","author":"S Suganuma","year":"2025","unstructured":"Suganuma S, Kanda N, Yoshida M, Miyagi T, Nakamura K. Use of C-reactive protein in Global Leadership Initiative on Malnutrition (GLIM) etiologic criteria for critically ill patients: a retrospective claims database study. Nutrients. 2025;17(4):705. https:\/\/doi.org\/10.3390\/nu17040705.","journal-title":"Nutrients"},{"issue":"10","key":"3870_CR8","doi-asserted-by":"publisher","first-page":"1111727","DOI":"10.3389\/fmed.2023.1111727","volume":"22","author":"GR Lee","year":"2023","unstructured":"Lee GR, Kim EY. Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients. Front Med (Lausanne). 2023;22(10):1111727. https:\/\/doi.org\/10.3389\/fmed.2023.1111727.","journal-title":"Front Med (Lausanne)"},{"key":"3870_CR9","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jcrc.2017.03.013","volume":"40","author":"YH Lee","year":"2017","unstructured":"Lee YH, Lee JD, Kang DR, Hong J, Lee JM. Bioelectrical impedance analysis values as markers to predict severity in critically ill patients. J Crit Care. 2017;40:103\u20137. https:\/\/doi.org\/10.1016\/j.jcrc.2017.03.013.","journal-title":"J Crit Care"},{"key":"3870_CR10","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20021608","author":"S Praget-Bracamontes","year":"2023","unstructured":"Praget-Bracamontes S, Gonz\u00e1lez-Arellanes R, Aguilar-Salinas CA, Martag\u00f3n AJ. Phase angle as a potential screening tool in adults with metabolic diseases in clinical practice: a systematic review. Int J Environ Res Public Health. 2023. https:\/\/doi.org\/10.3390\/ijerph20021608.","journal-title":"Int J Environ Res Public Health"},{"issue":"3 Suppl","key":"3870_CR11","doi-asserted-by":"publisher","first-page":"388S","DOI":"10.1093\/ajcn\/64.3.388S","volume":"64","author":"KR Foster","year":"1996","unstructured":"Foster KR, Lukaski HC. Whole-body impedance--what does it measure? Am J Clin Nutr. 1996;64(3 Suppl):388S-396S. https:\/\/doi.org\/10.1093\/ajcn\/64.3.388S.","journal-title":"Am J Clin Nutr"},{"issue":"3","key":"3870_CR12","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1007\/s11154-022-09775-0","volume":"24","author":"BR da Silva","year":"2023","unstructured":"da Silva BR, Orsso CE, Gonzalez MC, Sicchieri JM, Mialich MS, Jordao AA, et al. Phase angle and cellular health inflammation and oxidative damage. Rev Endocr Metab Disord. 2023;24(3):543\u201362. https:\/\/doi.org\/10.1007\/s11154-022-09775-0. (Epub 2022 Dec 7).","journal-title":"Rev Endocr Metab Disord"},{"key":"3870_CR13","doi-asserted-by":"publisher","first-page":"1059747","DOI":"10.3389\/fmed.2022.1059747","volume":"9","author":"W-H Zheng","year":"2023","unstructured":"Zheng W-H, Zhao Y-H, Yao Y, Huang H-B. Prognostic role of bioelectrical impedance phase angle for critically ill patients: A systemic review and meta-analysis. 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