Low-phase angle in body composition measurements correlates with prolonged hospital stay in head and neck cancer patients

Abstract

Background: Bioelectrical impedance analysis (BIA) is a method for estimating body composition. Clinically the most important parameter is the phase angle (PA), which decreases with progressing malnutrition and is highly predictive for impaired survival and mortality.

Aim: To evaluate the association of low PA with the complication rate and length of hospital stay.

Material and methods: A cohort of 61 head and neck cancer (HNC) patients underwent BIA prior to surgical treatment. Information on patient and tumour characteristics, treatment, and surgical complications were gathered from hospital records and correlated with BIA results.

Results: The median PA was 4.5 (range, 2.7–6.5), and, in 67% of the patients, it was lower than reference values. Low PA was associated with longer hospital stay (p = .002) in the whole cohort and in the patient group with radical neck dissections it correlated with a higher surgical complication rate (p = .014), but not with Clavien–Dindo scoring for surgical complications.

Conclusions and significance: BIA is a feasible instrument for analysing body composition that reflects nutritional status in cancer patients. Our results show that HNC patients have a low PA at diagnosis. Low PA is associated with a long hospital stay and an increase in the complication rate. BIA can be of clinical value in preoperative risk evaluation.

Chinese abstract

背景：生物电阻抗分析（BIA）是一种估算人体成分的方法。临床上最重要的参数是相位角（PA）, 它随着营养不良程度的加深而降低, 对受损生存和死亡率有很高的预测性。

目的：探讨低PA与并发症发生率及住院时长的关系。

材料与方法：对61例头颈癌（HNC）患者进行了术前BIA。从医院记录中获取有关患者、肿瘤特征、治疗和手术并发症的信息, 并与BIA结果进行相关比较。

结果：PA中位数为4.5（范围：2.7-6.5）, 67%患者的PA低于预期值。在整个患者群中, 低PA与较长的住院时间相关（P=.002）；而在接受根治性颈部解剖的患者组中, 低PA与较高的手术并发症发生率相关（P=.014）, 但与手术并发症Clavien–Dindo评分无关。

结论与意义：BIA是一种可行的身体成分分析工具。这样的身体成分可反映癌症患者营养状况。我们的结果表明, HNC患者在诊断时的PA较低。低PA与住院时间长和并发症发生率增加相关。BIA在术前风险评估中具有一定的临床价值。

Keywords:

• Nutritional risk screening
• surgery
• complication
• head and neck neoplasm
• bioelectrical impedance analysis
• NRS-2002

Acknowledgements

The authors thank statistician M.Sc. (Tech) Timo Pessi for his services.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was funded by the Helsinki University Hospital Research Funding, and the Dorothea Olivia, Karl Walter, and Jarl Walter Perkén’s Foundation.