Assessment of Computed Tomography-Defined Muscle and Adipose Tissue Features in Relation to Length of Hospital Stay and Recurrence of Hypertriglyceridemic Pancreatitis

Abstract

Background: Analytic morphometric assessment has recently been proposed to be applied to the study of acute pancreatitis (AP). However, the relationship between body composition and the outcomes of hypertriglyceridemic pancreatitis (HTGP) is still unclear. The aim of this study was to evaluate body composition in relation to the length of hospital stay (LOS) and recurrence of HTGP.Methods: Patient characteristics, admission examination data, body composition parameters, LOS, and recurrence within 1 year were collected from the institutional pancreatitis database and follow-up records. Logistic regression analysis was used to identify risk factors for LOS and recurrence of HTGP.Results: Of the 196 included patients, 158 (80.6%) were men and 53 (27.0%) were sarcopenic. The average LOS was 15.83±10.02 days. The recurrence rate of HTGP was 36.7%. Multivariate analysis with multiple linear regression suggested that subcutaneous fat area (SFA) (p=0.019) and high-density lipoprotein-cholesterol (HDL-C) (p=0.001) were independently associated with the LOS for HTGP after adjusting for age and sex. The multivariate adjusted hazard ratios for SFA and HDL-C, with respect to the relationship between body parameters and LOS, were 1.008 (95% confidence interval [CI], 1.001–1.015) and 0.090 (95% CI, 0.022–0.361), respectively. No significant differences were observed between the AP and recurrent AP (RAP) groups in terms of characteristics, admission examination data, and body composition parameters.Conclusion: SFA and HDL-C are associated with LOS in patients with HTGP. The body composition of patients at the first symptom onset of HTGP cannot predict recurrence.

Definition, diagnosis, and treatment of respiratory sarcopenia

“…CT images can evaluate respiratory muscle mass in the chest [13,14]. Respiratory muscles that can be evaluated with CT include the diaphragm [15], pectoralis muscle [16,17], erector spinae [18], iliopsoas, and the abdominal muscle groups. Each method for evaluating respiratory muscle strength and muscle mass has its own characteristics (Table 1).…”

“…The modified nutritional risk in critically ill (mNUTRIC) score is an independent predictor of thinner abdominal expiratory muscles in mechanically ventilated critically ill patients [33]. Diaphragm thickness is significantly associated with malnutrition at admission in patients with severe and critical coronavirus disease-2019 (COVID-19) [15]. Diaphragm thickness is significantly thinner in pediatric patients with primary malnutrition than in the healthy control group [34].…”