J Gastric Cancer.  2019 Sep;19(3):278-289. 10.5230/jgc.2019.19.e22.

Bioelectrical Impedance Analysis for Prediction of Early Complications after Gastrectomy in Elderly Patients with Gastric Cancer: the Phase Angle Measured Using Bioelectrical Impedance Analysis

• Yu B
• Park KB
• Park JY
• Lee SS
• Kwon OK
• Chung HY

• KMID: 2458828
• DOI: http://doi.org/10.5230/jgc.2019.19.e22

Abstract

PURPOSE
Phase angle obtained using bioelectrical impedance analysis (BIA) provides a relatively precise assessment of the nutritional status of elderly patients. This study aimed to evaluate the significance of phase angle as a risk factor for complications after gastrectomy in elderly patients.
MATERIALS AND METHODS
We evaluated 210 elderly patients (aged ≥65 years) who had undergone gastrectomy for gastric cancer between August 2016 and August 2017. The phase angle cutoff value was calculated using receiver operating characteristic curve analysis according to sex. A retrospective analysis regarding the correlation between early postoperative complications and well-known risk factors, including the phase angle, was performed.
RESULTS
Multivariate analysis revealed that the presence of two or more comorbidities (odds ratio [OR], 3.675) and hypoalbuminemia (OR, 4.059) were independent risk factors for overall complications, and female sex (OR, 2.993) was independent risk factor for severe complications. A low phase angle (OR, 2.901 and 4.348, respectively) and total gastrectomy (OR, 4.718 and 3.473, respectively) were independent risk factors for both overall and severe complications.
CONCLUSIONS
Our findings show that preoperative low phase angle predicts the risk of overall and severe complications. Our findings suggest that BIA should be performed to assess the risk of postoperative complications in elderly patients with gastric cancer.

Keyword

Phase angle; Elderly; Gastrectomy; Stomach neoplasms; Postoperative complications

MeSH Terms

Aged*
Comorbidity
Electric Impedance*
Female
Gastrectomy*
Humans
Hypoalbuminemia
Multivariate Analysis
Nutritional Status
Postoperative Complications
Retrospective Studies
Risk Factors
ROC Curve
Stomach Neoplasms*

Figure

• 

  Fig. 1 Geometrical relationship between impedance (Z), reactance (Xc), resistance (R), and phase angle (PA).

• 

  Fig. 2 Receiver operating characteristics curve showing the sensitivity and specificity of the nutritional indices for predicting postoperative complications: (A) NLR, (B) PNI, and phase angle for male (C) and female (D) individuals. AUC = area under the curve; NLR = neutrophil/lymphocyte ratio; PNI = prognostic nutritional index.

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