Journal of Gastric Cancer

  • 제19권3호
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  • Pages.278-289
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  • 2019
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Bioelectrical Impedance Analysis for Prediction of Early Complications after Gastrectomy in Elderly Patients with Gastric Cancer: the Phase Angle Measured Using Bioelectrical Impedance Analysis

  • Yu, Byunghyuk (Gastric Cancer Center, Kyungpook National University Chilgok Hospital) ;
  • Park, Ki Bum (Gastric Cancer Center, Kyungpook National University Chilgok Hospital) ;
  • Park, Ji Yeon (Gastric Cancer Center, Kyungpook National University Chilgok Hospital) ;
  • Lee, Seung Soo (Department of Surgery, School of Medicine, Kyungpook National University) ;
  • Kwon, Oh Kyoung (Gastric Cancer Center, Kyungpook National University Chilgok Hospital) ;
  • Chung, Ho Young (Department of Surgery, School of Medicine, Kyungpook National University)
  • 투고 : 2019.02.26
  • 심사 : 2019.05.20
  • 발행 : 2019.09.30
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초록

Purpose: Phase angle obtained using bioelectrical impedance analysis (BIA) provides a relatively precise assessment of the nutritional status of elderly patients. This study aimed to evaluate the significance of phase angle as a risk factor for complications after gastrectomy in elderly patients. Materials and Methods: We evaluated 210 elderly patients (aged ${\geq}65years$) who had undergone gastrectomy for gastric cancer between August 2016 and August 2017. The phase angle cutoff value was calculated using receiver operating characteristic curve analysis according to sex. A retrospective analysis regarding the correlation between early postoperative complications and well-known risk factors, including the phase angle, was performed. Results: Multivariate analysis revealed that the presence of two or more comorbidities (odds ratio [OR], 3.675) and hypoalbuminemia (OR, 4.059) were independent risk factors for overall complications, and female sex (OR, 2.993) was independent risk factor for severe complications. A low phase angle (OR, 2.901 and 4.348, respectively) and total gastrectomy (OR, 4.718 and 3.473, respectively) were independent risk factors for both overall and severe complications. Conclusions: Our findings show that preoperative low phase angle predicts the risk of overall and severe complications. Our findings suggest that BIA should be performed to assess the risk of postoperative complications in elderly patients with gastric cancer.

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참고문헌

  1. Takeshita H, Ichikawa D, Komatsu S, Kubota T, Okamoto K, Shiozaki A, et al. Surgical outcomes of gastrectomy for elderly patients with gastric cancer. World J Surg 2013;37:2891-2898. https://doi.org/10.1007/s00268-013-2210-7
  2. Information Committee of Korean Gastric Cancer Association. Korean Gastric Cancer Association nationwide survey on gastric cancer in 2014. J Gastric Cancer 2016;16:131-140. https://doi.org/10.5230/jgc.2016.16.3.131
  3. Polanczyk CA, Marcantonio E, Goldman L, Rohde LE, Orav J, Mangione CM, et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med 2001;134:637-643. https://doi.org/10.7326/0003-4819-134-8-200104170-00008
  4. Seiler WO. Clinical pictures of malnutrition in ill elderly subjects. Nutrition 2001;17:496-498. https://doi.org/10.1016/S0899-9007(01)00558-5
  5. Choi WJ, Kim J. Nutritional care of gastric cancer patients with clinical outcomes and complications: a review. Clin Nutr Res 2016;5:65-78. https://doi.org/10.7762/cnr.2016.5.2.65
  6. Lohsiriwat V. The influence of preoperative nutritional status on the outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery. Tech Coloproctol 2014;18:1075-1080. https://doi.org/10.1007/s10151-014-1210-4
  7. Zarowitz BJ, Pilla AM. Bioelectrical impedance in clinical practice. DICP 1989;23:548-555. https://doi.org/10.1177/1060028089023007-803
  8. Kyle UG, Genton L, Pichard C. Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission. Clin Nutr 2013;32:294-299. https://doi.org/10.1016/j.clnu.2012.08.001
  9. Baumgartner RN, Chumlea WC, Roche AF. Bioelectric impedance phase angle and body composition. Am J Clin Nutr 1988;48:16-23. https://doi.org/10.1093/ajcn/48.1.16
  10. Schwenk A, Beisenherz A, Romer K, Kremer G, Salzberger B, Elia M. Phase angle from bioelectrical impedance analysis remains an independent predictive marker in HIV-infected patients in the era of highly active antiretroviral treatment. Am J Clin Nutr 2000;72:496-501. https://doi.org/10.1093/ajcn/72.2.496
  11. Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 2002;86:509-516. https://doi.org/10.1007/s00421-001-0570-4
  12. Kuzu MA, Terzioglu H, Genc V, Erkek AB, Ozban M, Sonyurek P, et al. Preoperative nutritional risk assessment in predicting postoperative outcome in patients undergoing major surgery. World J Surg 2006;30:378-390. https://doi.org/10.1007/s00268-005-0163-1
  13. Hu WH, Cajas-Monson LC, Eisenstein S, Parry L, Cosman B, Ramamoorthy S. Preoperative malnutrition assessments as predictors of postoperative mortality and morbidity in colorectal cancer: an analysis of ACS-NSQIP. Nutr J 2015;14:91. https://doi.org/10.1186/s12937-015-0081-5
  14. Oliveira CM, Kubrusly M, Mota RS, Silva CA, Choukroun G, Oliveira VN. The phase angle and mass body cell as markers of nutritional status in hemodialysis patients. J Ren Nutr 2010;20:314-320. https://doi.org/10.1053/j.jrn.2010.01.008
  15. Gupta D, Lammersfeld CA, Burrows JL, Dahlk SL, Vashi PG, Grutsch JF, et al. Bioelectrical impedance phase angle in clinical practice: implications for prognosis in advanced colorectal cancer. Am J Clin Nutr 2004;80:1634-1638. https://doi.org/10.1093/ajcn/80.6.1634
  16. Gupta D, Lis CG, Dahlk SL, Vashi PG, Grutsch JF, Lammersfeld CA. Bioelectrical impedance phase angle as a prognostic indicator in advanced pancreatic cancer. Br J Nutr 2004;92:957-962. https://doi.org/10.1079/BJN20041292
  17. Gupta D, Lammersfeld CA, Vashi PG, King J, Dahlk SL, Grutsch JF, et al. Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. BMC Cancer 2008;8:249. https://doi.org/10.1186/1471-2407-8-249
  18. Kim HS, Lee ES, Lee YJ, Lee JH, Lee CT, Cho YJ. Clinical application of bioelectrical impedance analysis and its phase angle for nutritional assessment of critically Ill patients. J Clin Nutr 2015;7:54-61. https://doi.org/10.15747/jcn.2015.7.2.54
  19. Wirth R, Volkert D, Rosler A, Sieber CC, Bauer JM. Bioelectric impedance phase angle is associated with hospital mortality of geriatric patients. Arch Gerontol Geriatr 2010;51:290-294. https://doi.org/10.1016/j.archger.2009.12.002
  20. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187-196. https://doi.org/10.1097/SLA.0b013e3181b13ca2
  21. Lee KG, Lee HJ, Yang JY, Oh SY, Bard S, Suh YS, et al. Risk factors associated with complication following gastrectomy for gastric cancer: retrospective analysis of prospectively collected data based on the Clavien- Dindo system. J Gastrointest Surg 2014;18:1269-1277. https://doi.org/10.1007/s11605-014-2525-1
  22. Kang SC, Kim HI, Kim MG. Low serum albumin level, male sex, and total gastrectomy are risk factors of severe postoperative complications in elderly gastric cancer patients. J Gastric Cancer 2016;16:43-50. https://doi.org/10.5230/jgc.2016.16.1.43
  23. Hamakawa T, Kurokawa Y, Mikami J, Miyazaki Y, Takahashi T, Yamasaki M, et al. Risk factors for postoperative complications after gastrectomy in gastric cancer patients with comorbidities. Surg Today 2016;46:224-228. https://doi.org/10.1007/s00595-015-1175-6
  24. Seo SH, Hur H, An CW, Yi X, Kim JY, Han SU, et al. Operative risk factors in gastric cancer surgery for elderly patients. J Gastric Cancer 2011;11:116-121. https://doi.org/10.5230/jgc.2011.11.2.116
  25. Nagano M, Suita S, Yamanouchi T. The validity of bioelectrical impedance phase angle for nutritional assessment in children. J Pediatr Surg 2000;35:1035-1039. https://doi.org/10.1053/jpsu.2000.7766
  26. Araujo Antunes A, Alves Pereira Rodrigues AP, Geraix J, Vaz de Arruda Silveira L, Camara Marques Pereira P, Barros Leite Carvalhaes MA. Nutritional assessment of hospitalized HIV-infected patients by the phase angle z-score measurement. Nutr Hosp 2012;27:771-774.
  27. Wilhelm-Leen ER, Hall YN, Horwitz RI, Chertow GM. Phase angle, frailty and mortality in older adults. J Gen Intern Med 2014;29:147-154. https://doi.org/10.1007/s11606-013-2585-z
  28. Grundmann O, Yoon SL, Williams JJ. The value of bioelectrical impedance analysis and phase angle in the evaluation of malnutrition and quality of life in cancer patients--a comprehensive review. Eur J Clin Nutr 2015;69:1290-1297. https://doi.org/10.1038/ejcn.2015.126
  29. Varan HD, Bolayir B, Kara O, Arik G, Kizilarslanoglu MC, Kilic MK, et al. Phase angle assessment by bioelectrical impedance analysis and its predictive value for malnutrition risk in hospitalized geriatric patients. Aging Clin Exp Res 2016;28:1121-1126. https://doi.org/10.1007/s40520-015-0528-8
  30. Sungurtekin H, Sungurtekin U, Balci C, Zencir M, Erdem E. The influence of nutritional status on complications after major intraabdominal surgery. J Am Coll Nutr 2004;23:227-232. https://doi.org/10.1080/07315724.2004.10719365
  31. Schiesser M, Muller S, Kirchhoff P, Breitenstein S, Schafer M, Clavien PA. Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery. Clin Nutr 2008;27:565-570. https://doi.org/10.1016/j.clnu.2008.01.010
  32. Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Terashima M. Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer. Ann Surg Oncol 2013;20:1575-1583. https://doi.org/10.1245/s10434-012-2720-9
  33. Barbosa-Silva MC, Barros AJ, Wang J, Heymsfield SB, Pierson RN Jr. Bioelectrical impedance analysis: population reference values for phase angle by age and sex. Am J Clin Nutr 2005;82:49-52. https://doi.org/10.1093/ajcn/82.1.49
  34. Bosy-Westphal A, Danielzik S, Dorhofer RP, Later W, Wiese S, Muller MJ. Phase angle from bioelectrical impedance analysis: population reference values by age, sex, and body mass index. JPEN J Parenter Enteral Nutr 2006;30:309-316. https://doi.org/10.1177/0148607106030004309

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