Authors
Tomohiko Yasuda, Daisuke Kakinuma, Issei Inoue, Daichi Watanabe, Komei Kuge, Keisuke Minamimura, Satoshi Matsumoto, Yoshiharu Nakamura, Akihisa Matsuda, Hiroshi Yoshida
Published in
Surgery today. Jul 24, 2026. Epub Jul 24, 2026.
Abstract
Postoperative infectious complications (POI) after gastrectomy remain a major concern. While bioelectrical impedance analysis (BIA) is used for nutritional assessment, the clinical relevance of the preoperative extracellular water-to-total body water ratio (ECW/TBW) remains unclear. We investigated the association between preoperative ECW/TBW and POI.
This single-center retrospective cohort study included 181 patients who underwent curative gastrectomy between November 2020 and October 2025. Preoperative ECW/TBW was measured using multifrequency BIA. The primary outcome was POI, defined as surgical site infection (SSI) and/or remote infection (RI) within 30 days. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed.
POI developed in 44 patients (24.3%), as SSI in 30 (16.6%) and as RI in 16 (8.8%). Multivariable analysis identified that a higher ECW/TBW was associated with POI (odds ratio [OR] per 0.01 increase, 1.68; 95% confidence interval [CI], 1.02-2.77; P = 0.040) and RI (OR 1.79; 95% CI, 1.00-3.21; P = 0.048), but not with SSI. ROC analysis showed a numerically higher AUC of ECW/TBW for predicting RI (area under the curve, 0.833) than phase angle (0.761).
Elevated ECW/TBW may reflect systemic physiological vulnerability associated with RI, particularly postoperative respiratory infection.
PMID:
42496897
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.
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