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Purpose <p>Phase angle (PA), derived from bioelectrical impedance-analysis (BIA) has emerged as a reliable marker predicting clinical outcomes. This prospective observational study investigated the association between PA and a composite in-hospital outcome in major abdominal surgery.</p> Methods <p>Each patient underwent BIA before surgery (PA<sub>pre</sub>), immediately postoperatively (PA<sub>post</sub>), and 1 day postoperatively (PA<sub>POD1</sub>). Specific assessment for frailty and nutrition status was performed before surgery. Patient outcomes were assessed using a composite adverse outcome comprising death, myocardial infarction, revascularization, stroke, hemodynamic instability, acute kidney injury, pulmonary complications, delirium, ileus, and surgical complications during hospitalization. One-year complication, including all-cause mortality, myocardial infarction, stroke, surgical complications, and readmission after discharge within the year were also assessed.</p> Results <p>A total of 122 adults who underwent major abdominal surgery were enrolled from July 2019 and April 2021. Twenty-three patients (53.5%) in the lower PA group (PA &lt; 5) experienced in-hospital complications compared to 38 patients (34.2%) in the higher PA group (PA ≥ 5) (relative risk, 1.6; 95% confidence interval [CI], 1.0 to 2.4; <i>p</i> = 0.038). PA<sub>pre</sub> was significantly associated with in-hospital complications (odds ratio, 0.491; 95% CI, 0.279 to 0.862; <i>p</i> &lt; 0.001). Patients with lower PA<sub>pre</sub> had a higher degree of frailty, and poor nutritional status. However, PA<sub>pre</sub> was not significantly associated with 1-year composite complications.</p> Conclusion <p>Low PA<sub>pre</sub> was associated with adverse postoperative outcomes after major abdominal surgery. PA can be a reliable prognostic factor to predict in-hospital complications in patients undergoing major abdominal surgery, serving as an alternative surrogate to frailty indices and nutritional markers.</p> <p><b>Trial registration:</b> Clinical Research Information Services of the Republic of Korea (CRIS identifier: KCT0004160).</p>

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Phase angle as a prognostic factor for postoperative outcomes in major abdominal surgery: a single-center prospective observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月13日

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  • Yu Jeong Bang,
  • Dawoon Jeong,
  • Ji Hye Kwon,
  • Yang Jin Park,
  • Jeong‑Jin Min

摘要

Purpose

Phase angle (PA), derived from bioelectrical impedance-analysis (BIA) has emerged as a reliable marker predicting clinical outcomes. This prospective observational study investigated the association between PA and a composite in-hospital outcome in major abdominal surgery.

Methods

Each patient underwent BIA before surgery (PApre), immediately postoperatively (PApost), and 1 day postoperatively (PAPOD1). Specific assessment for frailty and nutrition status was performed before surgery. Patient outcomes were assessed using a composite adverse outcome comprising death, myocardial infarction, revascularization, stroke, hemodynamic instability, acute kidney injury, pulmonary complications, delirium, ileus, and surgical complications during hospitalization. One-year complication, including all-cause mortality, myocardial infarction, stroke, surgical complications, and readmission after discharge within the year were also assessed.

Results

A total of 122 adults who underwent major abdominal surgery were enrolled from July 2019 and April 2021. Twenty-three patients (53.5%) in the lower PA group (PA < 5) experienced in-hospital complications compared to 38 patients (34.2%) in the higher PA group (PA ≥ 5) (relative risk, 1.6; 95% confidence interval [CI], 1.0 to 2.4; p = 0.038). PApre was significantly associated with in-hospital complications (odds ratio, 0.491; 95% CI, 0.279 to 0.862; p < 0.001). Patients with lower PApre had a higher degree of frailty, and poor nutritional status. However, PApre was not significantly associated with 1-year composite complications.

Conclusion

Low PApre was associated with adverse postoperative outcomes after major abdominal surgery. PA can be a reliable prognostic factor to predict in-hospital complications in patients undergoing major abdominal surgery, serving as an alternative surrogate to frailty indices and nutritional markers.

Trial registration: Clinical Research Information Services of the Republic of Korea (CRIS identifier: KCT0004160).