Performance evaluation of phase angle and handgrip strength in patients undergoing cardiac surgery: Prospective cohort study

Background and aims: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity. This study aimed to evaluate the behaviour of PA and HGS in patients undergoing cardiac surgery and associate these factors with clinical outcomes and prognosis. Methods: This was a prospective cohort study of 50 consecutively recruited patients (aged >= 18 years) undergoing cardiac surgery. Measures PA and HGS were at three set points: preoperative, at hospital discharge and three months postoperative. The following data were collected: time of cardiopulmonary bypass (CPB), ischemia, mechanical ventilation (MV), Intensive Care Unit (ICU) length of stay (LOS) and hospital LOS after surgery; the EuroSCORE was also calculated. Results: A decrease in PA was observed between the preoperative and the two postoperative stages (p < 0.001). There was a reduction in HGS between the preoperative and hospital discharge assessments (p < 0.001) and a recovery three months postoperative (p < 0.001). The MV and EuroSCORE were inversely associated with PA and HGS in all three assessments. The PA was correlated with EuroSCORE in the first assessment (p = 0.007) and in the second and third assessments (p < 0.001), as well as with MV in all three assessments (p < 0.001). The HGS was correlated with EuroSCORE and MV in the first and second assessments (p < 0.001) and in the third assessment (p = 0.010 and p = 0.018, respectively). Conclusion: PA and HGS appear to be related to MV time, ICU LOS and hospital LOS after surgery in patients undergoing cardiac surgery. (c) 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.