The Relationship between Phase Angle, Nutrition Status, and Complications in Patients with Pancreatic Head Cancer

Abstract

Phase angle (PhA), a bioimpedance parameter, is used to assess the nutrition status and body composition of patients. Patients with pancreatic head cancer often present with body composition changes that relate to adverse outcomes. PhA may be useful to evaluate prognosis in these patients, but data are deficient. We aim to explore the effects of PhA on nutrition evaluation and short-term outcome prediction in these patients. This prospective study included 49 participants with pancreatic head cancer who underwent pancreaticoduodenectomy (PD). All participants’ nutritional status and postoperative complications were assessed using nutrition assessment tools and the Clavien−Dindo classification method, respectively. Spearman correlation analyses were used to evaluate the association between PhA, nutrition status, and postoperative complications. ROC curves were generated to evaluate the ability of PhA to predict malnutrition and complications and to determine the cutoff value. The PhA values of the nutritional risk group and the malnourished group were significantly lower than those of the well-nourished group (p < 0.05). PhA positively correlated with patients’ nutrition status. Nineteen patients had postoperative complications, and the PhA value of the complication group was significantly lower than that of the non-complication group (4.94 vs. 5.47, p = 0.013). ROC curves showed that the cutoff point of PhA to predict malnutrition was 5.45 (AUC: 0.744), and the cutoff point of PhA to predict postoperative complications was 5.35 (AUC: 0.717). Our study indicates that PhA was associated with nutrition status and could be considered a nutrition assessment tool for pancreatic head cancer patients and predict the postoperative complications of these patients who have undergone PD.

Keywords: bioelectrical impedance analysis; complications; nutrition status; pancreatic head cancer; phase angle.

Figure 1

Selection of participants analyzed in this study. BIA, bioelectrical impedance analysis.

Figure 2

Venn diagram about the number of participants with malnutrition status according to the different nutritional status assessment methods.

Figure 3

ROC curves of PhA to predict the patient nutrition status according to Nutritional Risk Screening 2002 (NRS-2002, (a)), Subjective Global Assessment (SGA, (b)), and Global Leadership Initiative on Malnutrition (GLIM, (c)). AUC: Area under the curve.

Figure 4

ROC curves of PhA to predict the postoperative complications and bar graphs of PhA values between the complication group and the non-complication group. (a) The results of 49 participants with pancreatic head cancer. (b) The results of 74 participants who underwent pancreaticoduodenectomy. * p < 0.05.