Low phase angle in hepatobiliary and pancreatic surgery inpatients and its impact on clinical outcomes: A cross-sectional study

This study investigates abnormalities in bioimpedance phase angle (PA) among hepatobiliary and pancreatic surgery inpatients and analyzes their impact on clinical outcomes for surgical patients. A cross-sectional study method was employed to analyze general data, body mass index (BMI), grip strength, step speed, appendicular skeletal muscle index (ASMI), serology-related indices, body composition analysis, and NRS 2002 scores of hepatobiliary and pancreatic surgery inpatients admitted between December 2019 and September 2022. Comorbidity with sarcopenia was determined for each patient. Regarding PA, a bioelectrical impedance of <5.0° in men and <4.6° in women at 50 kHz was judged to be abnormal. The relationship between PA and sarcopenia and nutritional assessment indicators was examined with the help of univariate and multivariate logistic regression. A total of 1305 inpatients met the inclusion criteria, with 334 (25.59%) having a low phase angle. The PA abnormality rate was 6.57% for the participants under 60 years old, and 41.49% for those 60 or over. There were 349 patients with malignant disease and 956 with benign disease, and the rate of PA abnormalities in patients with malignant tumors was 28.94% and 24.37%. In 71 emaciated cases, 567 normal body masses, and 687 overweight body masses, the abnormal PA rates were 71.83%, 30.51%, and 16.01%, respectively. BMI, serum albumin level, hemoglobin level, NRS 2002 score, and age were identified as factors influencing PA (P < .05). Compared with the normal PA group, the low PA group had significantly decreased handgrip strength, ASMI, and skeletal muscle mass. The low PA group also exhibited a significantly higher prevalence of nutritional risk and sarcopenia compared to the control group (P < .001). Among the 720 surgical patients, the incidence of postoperative complications was significantly higher in the low PA group (33.60%) than in the normal PA group (17.48%) (P < .001), with prolonged postoperative hospital stay (P < .001). The prevalence of low PA was notably high among hospitalized patients who underwent hepatobiliary and pancreatic surgery. A low PA status predicts a higher nutritional risk and poorer muscle strength and function. Furthermore, low PA is associated with increased postoperative complication rates and prolonged hospitalization in surgical patients.