Phase angle as a predictor of complications in acute stroke: A cohort study

BACKGROUND AND AIMS: Complications following acute stroke can worsen prognosis. Skeletal muscle mass and quality may influence these outcomes. To investigate the association between skeletal muscle quantity and quality with the incidence of complications in patients hospitalized for acute stroke. METHODS AND RESULTS: This single center prospective cohort study evaluated 646 consecutive patients who were hospitalized for acute stroke (women: 45 %, hemorrhagic stroke: 20 %). The main study outcome was the occurrence of complications during acute hospitalization. Skeletal muscle mass and quality were assessed via bioelectrical impedance analysis, with skeletal muscle index (SMI) representing mass and phase angle (PhA) reflecting quality. A binary logistic regression analysis was performed to determine the factors that were associated with the occurrence of complications upon admission. A total of 179 patients (27.7 %) experienced complications. These individuals were significantly older, had lower body mass index, higher NIH Stroke Scale (NIHSS) scores, and poorer nutritional status. Multivariate analysis showed that higher NIHSS (OR 1.10, 95 % CI 1.08-1.13, p = 0.001), older age (OR 1.03, 95 % CI 1.00-1.05, p = 0.030), and lower PhA (OR 0.74, 95 % CI 0.57-0.97, p = 0.028) were independently associated with complications. SMI was not a significant predictor. CONCLUSIONS: PhA was independently associated with the occurrence of complications during acute hospitalization. Moreover, its evaluation in acute stroke is noninvasive and easy to perform, potentially enabling early prediction of complications.