Bang Yu Jeong, Jeong Dawoon, Kwon Ji Hye, Park Yang Jin, Min Jeong-Jin
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, 81 Irwon-Ro, Gangnam-Gu.
Department of Anesthesiology and Pain Medicine, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, Korea.
J Anesth. 2025 Jun 13. doi: 10.1007/s00540-025-03526-6.
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.
Each patient underwent BIA before surgery (PA), immediately postoperatively (PA), and 1 day postoperatively (PA). 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.
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). PA was significantly associated with in-hospital complications (odds ratio, 0.491; 95% CI, 0.279 to 0.862; p < 0.001). Patients with lower PA had a higher degree of frailty, and poor nutritional status. However, PA was not significantly associated with 1-year composite complications.
Low PA 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.
Clinical Research Information Services of the Republic of Korea (CRIS identifier: KCT0004160).
源自生物电阻抗分析（BIA）的相位角（PA）已成为预测临床结局的可靠标志物。这项前瞻性观察性研究调查了PA与 major abdominal surgery 住院综合结局之间的关联。
每位患者在手术前（PA）、术后即刻（PA）和术后1天（PA）接受BIA。术前对虚弱和营养状况进行了具体评估。使用包括死亡、心肌梗死、血运重建、中风、血流动力学不稳定、急性肾损伤、肺部并发症、谵妄、肠梗阻和住院期间手术并发症的综合不良结局评估患者结局。还评估了一年期并发症，包括全因死亡率、心肌梗死、中风、手术并发症以及出院后一年内再次入院情况。
2019年7月至2021年4月共纳入122例接受major abdominal surgery的成年人。低PA组（PA < 5）中有23例患者（53.5%）发生住院并发症，而高PA组（PA≥5）中有38例患者（34.2%）发生住院并发症（相对风险，1.6；95%置信区间[CI]，1.0至2.4；p = 0.038）。PA与住院并发症显著相关（比值比，0.491；95% CI，0.279至0.862；p < 0.001）。PA较低的患者虚弱程度更高，营养状况较差。然而，PA与一年期综合并发症无显著关联。
低PA与major abdominal surgery术后不良结局相关。PA可作为预测接受major abdominal surgery患者住院并发症的可靠预后因素，作为虚弱指数和营养标志物的替代指标。
大韩民国临床研究信息服务中心（CRIS标识符：KCT0004160）。
