{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T19:05:34Z","timestamp":1787684734320,"version":"build-2784847793"},"reference-count":46,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010621","name":"Medical University of Lublin","doi-asserted-by":"publisher","award":["672"],"award-info":[{"award-number":["672"]}],"id":[{"id":"10.13039\/501100010621","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: Malnutrition is a recognized risk factor for unfavorable clinical outcomes and complications in cardiovascular and surgical patients. Nutritional status can be assessed with various methods, and the phase angle (PA) derived from bioelectrical impedance analysis is one of the most reliable parameters for that purpose. Methods: The aim of this narrative review was to present the available data regarding PA application in cardiac surgery. After careful analysis of PubMed and Scopus databases, 21 articles were included in the final analysis. Results: PA is a parameter that can be used for nutritional status assessment in a cardiac surgery environment. It is suggested that it is more accurate than other criteria in malnutrition identification in this group of patients. The available data shows its association with mortality, length of intensive care unit stay, and hospital stay. It can also predict adverse events such as blood transfusion or mechanical ventilation. Conclusions: The available data underscores the usefulness of PA in preoperative risk assessment and post-procedural monitoring. PA could be introduced in everyday clinical assessment in cardiac surgery.<\/jats:p>","DOI":"10.3390\/nu17111914","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T10:21:49Z","timestamp":1748859709000},"page":"1914","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Application of Bioelectrical Impedance Analysis Phase Angle in Cardiac Surgery"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-8391","authenticated-orcid":false,"given":"Joanna","family":"Popiolek-Kalisz","sequence":"first","affiliation":[{"name":"Department of Clinical Dietetics, Medical University of Lublin, 20-059 Lublin, Poland"},{"name":"Department of Cardiology, Cardinal Wyszynski Hospital in Lublin, 20-718 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5159-6308","authenticated-orcid":false,"given":"Grzegorz","family":"Kalisz","sequence":"additional","affiliation":[{"name":"Department of Bioanalytics, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Zembala","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, John Paul II Catholic University of Lublin, 20-950 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"111280","DOI":"10.1016\/j.nut.2021.111280","article-title":"Phase Angle Measured by Bioelectrical Impedance Analysis and the Risk of Cardiovascular Disease among Adult Danes","volume":"89","author":"Langer","year":"2021","journal-title":"Nutrition"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"110865","DOI":"10.1016\/j.nut.2020.110865","article-title":"Bioelectrical Impedance Analysis\u2013Derived Phase Angle Is Related to Risk Scores of a First Cardiovascular Event in Adults","volume":"78","author":"Portugal","year":"2020","journal-title":"Nutrition"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1111\/ggi.13241","article-title":"Phase Angle Measured by Electrical Bioimpedance and Global Cardiovascular Risk in Older Adults","volume":"18","author":"Saad","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.nut.2011.11.033","article-title":"Bioelectrical Impedance Phase Angle as a Prognostic Marker in Chronic Heart Failure","volume":"28","year":"2012","journal-title":"Nutrition"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/14017431.2022.2060527","article-title":"Respiratory Failure and Bioelectrical Phase Angle Are Independent Predictors for Long-Term Survival in Acute Heart Failure","volume":"56","author":"Scicchitano","year":"2022","journal-title":"Scand. Cardiovasc. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1016\/j.clnu.2016.04.007","article-title":"Prognostic Role of Phase Angle in Hospitalized Patients with Acute Decompensated Heart Failure","volume":"35","author":"Alves","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"111774","DOI":"10.1016\/j.nut.2022.111774","article-title":"Is the Standardized Phase Angle a Predictor of Short- and Long-Term Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction? A Cohort Study","volume":"103\u2013104","author":"Queiroz","year":"2022","journal-title":"Nutrition"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/s41430-018-0159-1","article-title":"Phase Angle and Mortality: A Systematic Review","volume":"73","author":"Garlini","year":"2019","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Popiolek-Kalisz, J., Chrominski, T., Szczasny, M., and Blaszczak, P. (2024). Nutritional Status Predicts the Length of Stay and Mortality in Patients Undergoing Electrotherapy Procedures. Nutrients, 16.","DOI":"10.3390\/nu16060843"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Popiolek-Kalisz, J., Hollings, M., and Blaszczak, P. (2025). Nutritional Risk Score Predicts the Length of Stay in Patients Undergoing Coronary Angiography. Nutr. Diet., early view.","DOI":"10.1111\/1747-0080.70019"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Popiolek-Kalisz, J., and B\u0142aszczak, P. (2025). The Impact of Nutritional Risk on the Length of Stay in Patients Undergoing Percutaneous Coronary Interventions. Kardiol. Pol., early view.","DOI":"10.33963\/v.phj.106222"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4745","DOI":"10.1016\/j.clnu.2021.03.031","article-title":"ESPEN Practical Guideline: Clinical Nutrition in Surgery","volume":"40","author":"Weimann","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1007\/s00432-022-04175-y","article-title":"Current Status of the Association Between Malnutrition Defined by the GLIM Criteria and Postoperative Outcomes in Gastrointestinal Surgery for Cancer: A Narrative Review","volume":"149","author":"Matsui","year":"2022","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_14","unstructured":"World Health Organization World Health Organization (2019, April 01). BMI Classification. Global Database on Body Mass Index, Available online: http:\/\/www.who.int\/bmi\/index.jsp?introPage=intro_3.html."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clnu.2016.09.004","article-title":"ESPEN Guidelines on Definitions and Terminology of Clinical Nutrition","volume":"36","author":"Cederholm","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0261-5614(02)00214-5","article-title":"Nutritional Risk Screening (NRS 2002): A New Method Based on an Analysis of Controlled Clinical Trials","volume":"22","author":"Kondrup","year":"2003","journal-title":"Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.3346\/jkms.2018.33.e10","article-title":"Prevalence of Malnutrition in Hospitalized Patients: A Multicenter Cross-Sectional Study","volume":"33","author":"Kang","year":"2018","journal-title":"J. Korean Med. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101911","DOI":"10.1016\/j.cpcardiol.2023.101911","article-title":"Bioelectrical Impedance Analysis and Body Composition in Cardiovascular Diseases","volume":"48","author":"Szczygiel","year":"2023","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1038\/s41430-018-0335-3","article-title":"Bioelectrical Impedance Analysis for Body Composition Assessment: Reflections on Accuracy, Clinical Utility, and Standardisation","volume":"73","author":"Ward","year":"2019","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Popio\u0142ek, J., Teter, M., Kozak, G., Powr\u00f3zek, T., Mlak, R., Karaku\u0142a-Juchnowicz, H., and Ma\u0142ecka-Massalska, T. (2019). Anthropometrical and Bioelectrical Impedance Analysis Parameters in Anorexia Nervosa Patients\u2019 Nutritional Status Assessment. Medicina, 55.","DOI":"10.3390\/medicina55100671"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.12740\/PP\/67500","article-title":"Application of Phase Angle for Evaluation of the Nutrition Status of Patients with Anorexia","volume":"51","author":"Teter","year":"2017","journal-title":"Psychiatr. Pol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1177\/0148607106030004309","article-title":"Phase Angle From Bioelectrical Impedance Analysis: Population Reference Values by Age, Sex, and Body Mass Index","volume":"30","author":"Danielzik","year":"2006","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Gupta, D., Lammersfeld, C.A., Vashi, P.G., King, J., Dahlk, S.L., Grutsch, J.F., and Lis, C.G. (2008). Bioelectrical Impedance Phase Angle as a Prognostic Indicator in Breast Cancer. BMC Cancer, 8.","DOI":"10.1186\/1471-2407-8-249"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1079\/BJN20041292","article-title":"Bioelectrical Impedance Phase Angle as a Prognostic Indicator in Advanced Pancreatic Cancer","volume":"92","author":"Gupta","year":"2004","journal-title":"Br. J. Nutr."},{"key":"ref_25","first-page":"670","article-title":"The Phase Angle of the Electrical Impedance Is a Predictor of Long-Term Survival in Dialysis Patients","volume":"31","author":"Abad","year":"2011","journal-title":"Nefrologia"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1053\/j.jrn.2010.01.008","article-title":"The Phase Angle and Mass Body Cell as Markers of Nutritional Status in Hemodialysis Patients","volume":"20","author":"Oliveira","year":"2010","journal-title":"J. Ren. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1016\/j.clnu.2017.08.007","article-title":"Concordance of the New ESPEN Criteria with Low Phase Angle in Defining Early Stages of Malnutrition in Cardiac Surgery","volume":"37","author":"Ringaitiene","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.clnu.2012.05.002","article-title":"The Bioelectrical Impedance Phase Angle as an Indicator of Undernutrition and Adverse Clinical Outcome in Cardiac Surgical Patients","volume":"31","author":"Visser","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"99","DOI":"10.6001\/actamedica.v23i2.3326","article-title":"Preoperative Risk Factors of Malnutrition for Cardiac Surgery Patients","volume":"23","author":"Vicka","year":"2016","journal-title":"Acta Medica Litu."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e008721","DOI":"10.1161\/JAHA.118.008721","article-title":"Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study","volume":"7","author":"Mullie","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1016\/j.clnu.2016.02.010","article-title":"Malnutrition Assessed by Phase Angle Determines Outcomes in Low-Risk Cardiac Surgery Patients","volume":"35","author":"Ringaitiene","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1002\/jcsm.13514","article-title":"Association between Preoperative Phase Angle and All-Cause Mortality after Cardiovascular Surgery: A Retrospective Cohort Study","volume":"15","author":"Shibata","year":"2024","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1053\/j.jvca.2018.07.007","article-title":"Bioelectrical Impedance Phase Angle-Predictor of Blood Transfusion in Cardiac Surgery","volume":"33","author":"Ringaitiene","year":"2019","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/ALN.0000000000005024","article-title":"Postoperative Phase Angle and Prognosis after Cardiac Surgery: A Historical Cohort Study","volume":"141","author":"Ruste","year":"2024","journal-title":"Anesthesiology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1053\/j.jvca.2020.10.037","article-title":"Phase Angle and Handgrip Strength as Complements to Body Composition Analysis for Refining Prognostic Accuracy in Cardiac Surgical Patients","volume":"35","author":"Tsaousi","year":"2021","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1186\/s13019-022-01970-z","article-title":"Prognostic Value of Combined Preoperative Phase Angle and Handgrip Strength in Cardiac Surgery","volume":"17","author":"Panagidi","year":"2022","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1002\/ncp.11026","article-title":"Variations in Phase Angle and Handgrip Strength in Patients Undergoing Cardiac Surgery: Prospective Cohort Study","volume":"38","author":"Silva","year":"2023","journal-title":"Nutr. Clin. Pract."},{"key":"ref_38","first-page":"e30534","article-title":"Endothelial Damage and Muscle Wasting in Cardiac Surgery Patients","volume":"14","author":"Stavrou","year":"2022","journal-title":"Cureus"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.clnu.2017.06.020","article-title":"Bioimpedance Spectroscopy Measurements of Phase Angle and Height for Age Are Predictive of Outcome in Children Following Surgery for Congenital Heart Disease","volume":"37","author":"Marino","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ryz, S., Nixdorf, L., Puchinger, J., Lassnigg, A., Wiedemann, D., and Bernardi, M.H. (2022). Preoperative Phase Angle as a Risk Indicator in Cardiac Surgery-A Prospective Observational Study. Nutrients, 14.","DOI":"10.3390\/nu14122491"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.aucc.2017.09.002","article-title":"Performance Evaluation of Phase Angle and Handgrip Strength in Patients Undergoing Cardiac Surgery: Prospective Cohort Study","volume":"31","author":"Perry","year":"2018","journal-title":"Aust. Crit. Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"111402","DOI":"10.1016\/j.nut.2021.111402","article-title":"Association of Phase Angle with Hospital-Acquired Functional Decline in Older Patients Undergoing Cardiovascular Surgery","volume":"91\u201392","author":"Morisawa","year":"2021","journal-title":"Nutrition"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.clnu.2024.02.007","article-title":"The Severity of Early Fluid Overload Assessed by Bioelectrical Vector Impedance as an Independent Risk Factor for Longer Patient Care after Cardiac Surgery","volume":"43","author":"Sanson","year":"2024","journal-title":"Clin. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1017\/S1047951118000136","article-title":"Preoperative Bioelectrical Impedance Predicts Intensive Care Length of Stay in Children Following Cardiac Surgery","volume":"28","author":"Marino","year":"2018","journal-title":"Cardiol. Young"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"996","DOI":"10.33963\/v.phj.101942","article-title":"Bioelectrical Phase Angle among Individuals after Transcatheter Aortic Valve Implantation","volume":"82","author":"Gackowski","year":"2024","journal-title":"Pol. Heart J. (Kardiol. Pol.)"},{"key":"ref_46","first-page":"1","article-title":"Association between Skeletal Muscle Quality Assessed by Phase Angle, Peak Oxygen Uptake and Anaerobic Threshold in Male Patients with Coronary Artery Disease: A Cross-Sectional Study","volume":"75","author":"Takahashi","year":"2024","journal-title":"Hirosaki Med. J."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/11\/1914\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:46:15Z","timestamp":1760031975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/11\/1914"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["nu17111914"],"URL":"https:\/\/doi.org\/10.3390\/nu17111914","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,2]]}}}