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

Acta Otolaryngol. 2019 Apr;139(4):383-387. doi: 10.1080/00016489.2019.1566779. Epub 2019 Mar 22.

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.

Keywords: NRS-2002; Nutritional risk screening; bioelectrical impedance analysis; complication; head and neck neoplasm; surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Composition*
  • Cohort Studies
  • Electric Impedance*
  • Female
  • Head and Neck Neoplasms / complications*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Length of Stay*
  • Male
  • Middle Aged
  • Nutritional Status