Association of indirect measurement of cell function by bioimpedance analysis with complications in oncologic hepatic surgery

Background: Bioelectric impedance vector analysis (BIVA) is a reliable tool to assess body composi-tion. The aim was to study the association of BIVA-derived phase angle (PA) and standardized PA (SPA) values and the occurrence of surgery-related morbidity.Methods: Patients undergoing hepatectomy for cancer in two Italian centers were prospectively enrolled. BIVA was performed the morning of surgery. Patients were then stratified for the occurrence or not of postoperative morbidity.Results: Out of 190 enrolled patients, 76 (40%) experienced postoperative complications. Patients with morbidity had a significant lower PA, SPA, body cell mass, and skeletal muscle mass, and higher extracellular water and fat mass. At the multivariate analysis, presence of cirrhosis (OR 7.145, 95% CI:2.712-18.822, p < 0.001), the Charlson comorbidity index (OR 1.236, 95% CI: 1.009-1.515, p = 0.041), the duration of surgery (OR 1.004, 95% CI:1.001-1.008, p = 0.018), blood loss (OR 1.002. 95% CI: 1.001-1.004, p = 0.004), dehydration (OR 10.182, 95% CI: 1.244-83.314, p = 0.030) and SPA < -1.65 (OR 3.954, 95% CI: 1.699-9.202, p = 0.001) were significantly and independently asso-ciated with the risk of complications.Conclusion: Introducing BIVA before hepatic resections may add valuable and independent informa-tion on the risk of morbidity.

Automated summary

The aim of this study was to investigate the association between BIVA-derived phase angle and standardized phase angle and the occurrence of surgery-related morbidity. The results showed that patients with lower phase angle, standardized phase angle, body cell mass, and skeletal muscle mass, and higher extracellular water and fat mass were more likely to experience postoperative complications. Furthermore, the presence of cirrhosis, Charlson comorbidity index, duration of surgery, blood loss, dehydration, and standardized phase angle < -1.65 were significantly and independently associated with the risk of complications. Therefore, introducing BIVA analysis before hepatic resections can provide valuable and independent information on the risk of morbidity.