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Phase angle and extracellular edema predict risk of postoperative complications in total joint arthroplasties Cover

Phase angle and extracellular edema predict risk of postoperative complications in total joint arthroplasties

Journal of Electrical Bioimpedance
Volume 16 (2025): Issue 1 (January 2025)
By: ,  ,  ,  ,   and    
Open Access
|Mar 2025
Figures & tables

Figures & Tables

Figure 1:

Electrode placement (1).

Table 1:

PATIENT CHARACTERISTICS.

TJA complications
VariablesTotal (n=567)Non-complication (n=525)Complication (n=42)P-value
Age, median (IQR)66 [58–72]67 [59–73]65 [58–71]0.588
Sex, female316 (55.7)293 (55.8)23 (54.8)0.951
TKA311 (54.9)286 (54.5)25 (59.5)0.527
Race0.165
White529 (93.3)489 (93.1)40 (95.2)
Black21 (3.7)21 (4.0)0 (0.0)
Hispanic8 (1.41)7 (1.3)1 (2.4)
Asian6 (1.06)6 (1.1)0 (0.0)
Native Hawaiian/Pacific Islander2 (0.35)1 (0.2)1 (2.4)
Declined to answer1 (0.18)1 (0.2)0 (0.0)
Diabetes103 (18.2)98 (18.7)5 (11.9)0.272
HTN319 (56.3)297 (56.6)22 (52.4)0.598
Current smoker9 (1.59)8 (1.5)1 (2.4)0.669
Immunocompromised61 (10.8)53 (10.1)8 (19.0)0.072
Chronic kidney disease0.977
Stage 13 (0.53)3 (0.6)0 (0.0)
Stage 211 (1.94)10 (1.9)1 (2.4)
Stage 333 (5.82)31 (5.9)2 (4.8)
Stage 44 (0.71)4 (0.8)0 (0.0)
Stage 51 (0.18)1 (0.2)0 (0.0)
Lower extremities lymphedema9 (1.59)7 (1.3)2 (4.8)0.087
Lower extremities edema48 (8.47)45 (8.6)3 (7.1)0.749

[i] Data are presented as n (%) unless otherwise indicated

Table 2:

PREOPERATIVE LABORATORY.

VariablesNon-complication (n=525)Complication (n=42)P-value
HgbA1c6.53 (0.65)6.74 (0.74)0.499
Hgb13.77 (1.40)13.52 (1.52)0.282
Albumin4.40 [4.20–4.60]4.40 [4.10–4.50]0.110
Total protein7.10 [6.80–7.40]7.00 [6.80–7.30]0.929

[i] Data are presented as mean (SD) or median [IQR]

Table 3:

UNIVARIATE ANALYSIS.

VariablesNon-complication (n=525)Complication (n=42)P-valueAdjusted P-value (FDR)
ECW/ICW0.647 [0.632–0.666]0.657 [0.644–0.673]0.012*0.042*
ECW/TBW0.393 [0.387–0.400]0.396 [0.391–0.403]0.011*0.042*
SMI8.30 [7.20–9.30]8.40 [6.80–9.55]0.6510.750
PBF39.50 [32.90–46.80]38.50 [31.30–46.60]0.5060.708
VFA190 [137–238]194 [129–234]0.7500.750
Phase angle**4.80 [4.30–5.40]4.65 [4.13–5.00]0.039*0.091
BMI32.60 [28.30–37.70]32.00 [26.20–37.70]0.4740.708

* Significant correlations are less than 0.05

** 50 kHz – Whole Body Phase Angle

Data are presented as median [IQR]

Table 4:

MULTIVARIATE ANALYSIS.

VariablesOdds ratio (95% CI)P-value
Model 1: ECW/TBW
  ECW/TBW z-score1.65 (1.17–2.31)0.004*
  PBF0.96 (0.93–1.00)0.048*
  Immunocompromised2.22 (0.95–5.20)0.065
  Albumin0.48 (0.15–1.60)0.233
Model 2: ECW/ICW
  ECW/ICW z-score1.61 (1.15–2.23)0.005*
  PBF0.97 (0.93–1.00)0.051
  Immunocompromised2.23 (0.95–5.21)0.064
  Albumin0.47 (0.14–1.57)0.221
Model 3: Phase Angle
  Whole body ϕ0.58 (0.37–0.91)0.018*
  PBF0.96 (0.93–1.00)0.045*
  Immunocompromised2.16 (0.93–5.06)0.075
  Albumin0.43 (0.13–1.42)0.167
Model 4: BMI
  BMI1.65 (0.91–1.01)0.200
  Immunocompromised2.31 (0.98–5.47)0.063
  Albumin0.49 (0.15–1.67)0.067
Table 5:

ROC ANALYSIS.

ModelsAUC (95% CI)P-value
Model 1: ECW/TBW0.71 (0.62–0.79)<0.001
Model 2: ECW/ICW0.70 (0.62–0.79)<0.001
Model 3: Phase Angle0.69 (0.60–0.79)<0.001
Model 4: BMI0.61 (0.51–0.71)0.032
Table 6:

POSTOPERATIVE COMPLICATIONS.

TypeTotal (n=42)TKA (n=25)THA (n=17)
Deep joint infection16106
Delayed surgical wound healing422
Dislocation808
Arthrofibrosis*440
Revision surgery1798
ED visits**422

* Arthrofibrosis that required manual joint manipulation

** ED visits related to other postoperative complications not accounted for in the above categories.

Data are presented as n

DOI: https://doi.org/10.2478/joeb-2025-0005 | Journal eISSN: 1891-5469
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Language: English
Page range: 35 - 42
Submitted on: Nov 7, 2024
Published on: Mar 25, 2025
Published by: University of Oslo
In partnership with: Paradigm Publishing Services
Keywords:
Bioimpedance,
whole body phase angle,
extracellular edema,
arthroplasty
Related subjects:
Engineering,
Bioengineering and biomedical engineering,
Biomedical electronics,
Life sciences,
Biophysics,
Medicine,
Biomedical engineering,
Physics,
Spectroscopy and metrology

© 2025 Natalie Nguyen, Michael C. Marinier, Bryan Mouser, Victoria C. Tappa, Marshall Rupe, Jacob M. Elkins, published by University of Oslo
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 16 (2025): Issue 1 (January 2025)
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