Loss of muscle mass: a significant predictor of postoperative complications in acute diverticulitis

Matsushima, Kazuhide; Inaba, Kenji; Jhaveri, Vidhi; Cheng, Vincent Chi-Chung; Herr, Keith D.; Siboni, Stefano; Strumwasser, Aaron; Δημητριάδης, Δημήτριος

doi:10.1016/j.jss.2016.12.002

Cited by 20 publications

(19 citation statements)

References 22 publications

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“…6,11–13,19 Similarly, several studies have examined the association between CT-derived psoas area as a surrogate marker for sarcopenia and clinical outcomes with comparable results. 17,18,25–27 In contradiction to the majority of the literature, and similar to our results, a study by de Hoogt et al. demonstrated no statistically significant association between CT-derived sarcopenia and mortality in ICU patients on multivariate analysis.…”

Section: Discussionsupporting

confidence: 65%

“…The majority of the studies that have shown an association between CT-derived sarcopenia and poor clinical outcomes have targeted an older population (>65 years), examined a specific subgroup such as trauma and surgery patients, or a combination of both. 6,11,18,19,25–27 The heterogeneity of our study population with respect to age and admission diagnosis, in addition to the overall low mortality rate, may contribute to the lack of significance. Another potential explanation is the reasonably stringent pre-admission screening for admission to ICU in Australia.…”

Section: Discussionmentioning

confidence: 99%

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A retrospective observational study of sarcopenia and outcomes in critically ill patients

Joyce

O'Dempsey

Kirby

et al. 2020

Anaesth Intensive Care

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Frailty assessment in patients admitted to intensive care is often limited using traditional clinical frailty assessment tools. Opportunistic use of contemporary computed tomography (CT) can provide an objective estimate of low skeletal muscle mass (sarcopenia) as a proxy for frailty. The aim of this study was to establish the prevalence of sarcopenia in an Australian intensive care unit (ICU) population and to examine the relationship between sarcopenia and clinical outcomes. We undertook a single centre retrospective study of 1085 adult patients admitted to a single ICU over 12 months. Patients with a contemporary CT scan including the L3 vertebral body were included. Patients were categorised as sarcopenic or non-sarcopenic using previously published data. A total of 279 patients with a mean age of 67 years had an eligible CT scan; 163 (58%) were male. Higher 30-day mortality was associated with the use of CRRT (continuous renal replacement therapy) during the ICU admission (OR 6.84, P < 0.001) and also associated with lower cross-sectional muscle area (odds ratio (OR) 0.98, P = 0.004). Sarcopenia was found to be highly prevalent in this particular Australian ICU population (68%) and associated with older age (68 versus 55 years, P < 0.001), lower body mass index (27 versus 32 kg m−2, P < 0.001), more comorbidities (3 versus 2, P = 0.009), and longer stays in hospital (279 versus 223 h, P = 0.043). As a continuous predictor, lumbar muscle mass was associated with 30-day mortality with and without adjusting for other covariates.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

A retrospective observational study of sarcopenia and outcomes in critically ill patients

Joyce

O'Dempsey

Kirby

et al. 2020

Anaesth Intensive Care

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“…A total of six articles reported the incidence of postoperative complications in the emergency department, with a total of 2737 patients [ 5 , 17 , 35 – 38 ]. There was low heterogeneity among the included articles ( I 2 = 33%, P = 0.19).…”

Section: Resultsmentioning

confidence: 99%

Effect of sarcopenia in predicting postoperative mortality in emergency laparotomy: a systematic review and meta-analysis

Luo

Deng

et al. 2022

World J Emerg Surg

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Background While emergency laparotomy has been associated with high rates of postoperative mortality and adverse events, preoperative systematic evaluation of patients may improve perioperative outcomes. However, due to the critical condition of the patient and the limited operation time, it is challenging to conduct a comprehensive evaluation. In recent years, sarcopenia is considered a health problem associated with an increased incidence of poor prognosis. This study aimed to investigate the effect of sarcopenia on 30-day mortality and postoperative adverse events in patients undergoing emergency laparotomy. Methods We systematically searched databases including PubMed, Embase, and Cochrane for all studies comparing emergency laparotomy in patients with and without sarcopenia up to March 1, 2022. The primary outcome was of 30-day postoperative mortality. Secondary outcomes were the length of hospital stay, the incidence of adverse events, number of postoperative intensive care unit (ICU) admissions, and ICU length of stay. Study and outcome-specific risk of bias were assessed using the Quality in Prognosis Studies (QUIPS) tool. We rated the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Result A total of 11 eligible studies were included in this study. The results showed that patients with sarcopenia had a higher risk of death 30 days after surgery (OR = 2.42, 95% CI = 1.93–3.05, P < 0.00001). More patients were admitted to ICU after surgery (OR = 1.58, 95% CI = 1.11–2.25, P = 0.01). Both the ICU length of stay (MD = 0.55, 95% CI = 0.05–1.06, P = 0.03) and hospital length of stay (MD = 2.33, 95% CI = 1.33–3.32, P < 0.00001) were longer in the sarcopenia group. The incidence of postoperative complications was also significantly higher in patients with sarcopenia (OR = 1.78, 95% CI = 1.41–2.26, P < 0.00001). Conclusion In emergency laparotomy, sarcopenia was associated with increased 30-day postoperative mortality. Both the lengths of stay in the ICU and the total length of hospital stay were significantly higher than those in non-sarcopenic patients. Therefore, we concluded that sarcopenia can be used as a tool to identify preoperative high-risk patients, which can be considered to develop new postoperative risk prediction models. Registration number Registered on Prospero with the registration number of CRD42022300132.

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“…As preoperative abdominopelvic CT studies are usually performed in patients who have clinical signs of peritonitis in the Emergency Department, these images are readily available for evaluation of the psoas muscle mass. In a previous study, sarcopenia was significantly associated with worse patient outcomes, including mortality, complications, and discharge in patients who underwent emergency operations (13,16). Furthermore, Zuckerman et al demonstrated that a low psoas muscle area was associated with an increased postoperative length of stay after cardiac surgery (17).…”

Section: Discussionmentioning

confidence: 97%

The Impact of Low Muscle Mass in Patients Undergoing Emergency Surgery for Colonic Perforation – A Single-center Experience

Imamura

Haraguchi

Minami

et al. 2019

In Vivo

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Aim: The aim was to analyze the correlation between psoas muscle mass and mortality, as well as postoperative complications in patients treated for colonic perforation. Patients and Methods: A total of 46 patients met the study criteria. Patients were classified into an elderly (age, ≥75 years, n=24) and a younger group (age, <75 years, n=22). Background factors, postoperative data (including duration of hospital stay and discharge) were collected. The cross-sectional area of the psoas muscle area (PMA) was measured on the same day of operation. Results: The age/length of stay and PMA were significantly correlated in the younger group (p=0.0015, 0.023, respectively). Fifteen and six patients were discharged to return home, and 8 and 16 patients were transferred to another hospital, in the younger and elderly groups, respectively (p=0.02). Discharge was not correlated with the PMA in either group. Conclusion: The total psoas muscle mass would be useful as a quick and convenient measure of sarcopenia in younger patients, but not elderly patients.Sarcopenia is a syndrome characterized by a progressive and generalized loss of skeletal muscle mass and strength and is associated with an increased risk of adverse outcomes, such as physical disability, a poor quality of life, 523 This article is freely accessible online.

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Loss of muscle mass: a significant predictor of postoperative complications in acute diverticulitis

Cited by 20 publications

References 22 publications

A retrospective observational study of sarcopenia and outcomes in critically ill patients

A retrospective observational study of sarcopenia and outcomes in critically ill patients

Effect of sarcopenia in predicting postoperative mortality in emergency laparotomy: a systematic review and meta-analysis

The Impact of Low Muscle Mass in Patients Undergoing Emergency Surgery for Colonic Perforation – A Single-center Experience

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