Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients

PurposeBioelectrical impedance analysis (BIA) has advantages of obtaining results quickly, safely, reproducibly, and non-invasively. Phase angle (PhA) is one of the parameter of BIA, its values represent the permeability or integrity of cell membrane. With the exception of C-reactive protein (CRP),...

Full description

Bibliographic Details
Main Authors: Gyeo Ra Lee, Eun Young Kim
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-02-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2023.1111727/full
_version_ 1797900412721823744
author Gyeo Ra Lee
Eun Young Kim
author_facet Gyeo Ra Lee
Eun Young Kim
author_sort Gyeo Ra Lee
collection DOAJ
description PurposeBioelectrical impedance analysis (BIA) has advantages of obtaining results quickly, safely, reproducibly, and non-invasively. Phase angle (PhA) is one of the parameter of BIA, its values represent the permeability or integrity of cell membrane. With the exception of C-reactive protein (CRP), few studies have estimated an association between PhA and these conventional biomarkers. Herein, we aimed to investigate the association between the PhA value and the conventional inflammatory markers in postoperative patients in intensive care unit (ICU). Also, the correlation between the change in PhA and the occurrence of infectious complication were determined.MethodsFrom July 2020 to February 2022, retrospective observation study conducted in 221 patients who admitted to ICU after abdominal surgery. BIA measurements and blood sampling were routinely performed the next morning. The relationship between PhA and the inflammatory markers were assessed after adjusting for age and body mass index. Univariate and multivariate logistic regression analysis was performed to examine the predisposing factors for postoperative infections.ResultsAmong 221 patients admitted to ICU after abdominal surgery, infectious complications occurred in 62 cases. CRP, procalcitonin, or presepsin levels were negatively correlated with PhA in both gender. (−0.295, −0.198 or −0.212 of partial correlation coefficients, respectively in males, and 0.313, −0.245 or −0.36 of partial correlation coefficients, respectively in females) But, white blood cell did not show significant association with PhA in both genders. For males, increased level of CRP on postoperative day 1 (POD1) was revealed as the significant predicting factor for postoperative infectious complication [odds ratio (OR): 1.184, 95% confidence interval (CI): 1.090–1.285, p < 0.001]. For females, increased Acute Physiology and Chronic Health Evaluation II score at admission (OR: 1.457, 95% CI: 1.068–1.987, p = 0.018), increased level of presepsin on (OR: 1.003, 95% CI: 1.001–1.006, p = 0.016) and decreased value of PhA on POD1 (OR: 0.980, 95% CI: 0.967–0.993, p = 0.003) were revealed as the significant predicting factors.ConclusionPhase angle obtained through BIA can be used as a predictor of infection as it shows a significant association with inflammatory markers. Phase angle measurements through BIA could improve patient prognosis after abdominal surgery through the careful observation of infections and early, appropriate treatment.
first_indexed 2024-04-10T08:44:31Z
format Article
id doaj.art-31f929284a1643618441220d39a089ab
institution Directory Open Access Journal
issn 2296-858X
language English
last_indexed 2024-04-10T08:44:31Z
publishDate 2023-02-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj.art-31f929284a1643618441220d39a089ab2023-02-22T08:57:08ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-02-011010.3389/fmed.2023.11117271111727Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patientsGyeo Ra LeeEun Young KimPurposeBioelectrical impedance analysis (BIA) has advantages of obtaining results quickly, safely, reproducibly, and non-invasively. Phase angle (PhA) is one of the parameter of BIA, its values represent the permeability or integrity of cell membrane. With the exception of C-reactive protein (CRP), few studies have estimated an association between PhA and these conventional biomarkers. Herein, we aimed to investigate the association between the PhA value and the conventional inflammatory markers in postoperative patients in intensive care unit (ICU). Also, the correlation between the change in PhA and the occurrence of infectious complication were determined.MethodsFrom July 2020 to February 2022, retrospective observation study conducted in 221 patients who admitted to ICU after abdominal surgery. BIA measurements and blood sampling were routinely performed the next morning. The relationship between PhA and the inflammatory markers were assessed after adjusting for age and body mass index. Univariate and multivariate logistic regression analysis was performed to examine the predisposing factors for postoperative infections.ResultsAmong 221 patients admitted to ICU after abdominal surgery, infectious complications occurred in 62 cases. CRP, procalcitonin, or presepsin levels were negatively correlated with PhA in both gender. (−0.295, −0.198 or −0.212 of partial correlation coefficients, respectively in males, and 0.313, −0.245 or −0.36 of partial correlation coefficients, respectively in females) But, white blood cell did not show significant association with PhA in both genders. For males, increased level of CRP on postoperative day 1 (POD1) was revealed as the significant predicting factor for postoperative infectious complication [odds ratio (OR): 1.184, 95% confidence interval (CI): 1.090–1.285, p < 0.001]. For females, increased Acute Physiology and Chronic Health Evaluation II score at admission (OR: 1.457, 95% CI: 1.068–1.987, p = 0.018), increased level of presepsin on (OR: 1.003, 95% CI: 1.001–1.006, p = 0.016) and decreased value of PhA on POD1 (OR: 0.980, 95% CI: 0.967–0.993, p = 0.003) were revealed as the significant predicting factors.ConclusionPhase angle obtained through BIA can be used as a predictor of infection as it shows a significant association with inflammatory markers. Phase angle measurements through BIA could improve patient prognosis after abdominal surgery through the careful observation of infections and early, appropriate treatment.https://www.frontiersin.org/articles/10.3389/fmed.2023.1111727/fullinfectioninflammatory markerintensive care unitphase anglesurgery
spellingShingle Gyeo Ra Lee
Eun Young Kim
Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients
Frontiers in Medicine
infection
inflammatory marker
intensive care unit
phase angle
surgery
title Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients
title_full Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients
title_fullStr Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients
title_full_unstemmed Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients
title_short Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients
title_sort usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients
topic infection
inflammatory marker
intensive care unit
phase angle
surgery
url https://www.frontiersin.org/articles/10.3389/fmed.2023.1111727/full
work_keys_str_mv AT gyeoralee usefulnessofphaseangleonbioelectricalimpedanceanalysisasasurveillancetoolforpostoperativeinfectionincriticallyillpatients
AT eunyoungkim usefulnessofphaseangleonbioelectricalimpedanceanalysisasasurveillancetoolforpostoperativeinfectionincriticallyillpatients