Significance of osteopenia in elderly patients undergoing emergency gastrointestinal surgery

Abstract

Aim Frailty assessment in elderly patients is crucial to predict the postoperative course, considering that frailty is highly associated with postoperative complications and mortality. The aim of this study was to evaluate the value of osteopenia as a risk factor for severe postoperative complications in elderly patients who underwent emergency gastrointestinal surgery. Methods This study comprised 103 elderly patients who underwent emergency gastrointestinal surgery. Osteopenia was diagnosed by measuring bone mineral density, which was calculated as the average pixel density in the midvertebral core at the 11th thoracic vertebra on the preoperative plain computed tomography image. We retrospectively investigated the relationship between preoperative osteopenia and severe postoperative complications (Clavien–Dindo classification ≥III). Univariate and multivariate analyses were performed to evaluate the risk factors for severe postoperative complications. Results Twenty‐three patients (22.3%) developed severe postoperative complications. The optimal cutoff value of bone mineral density for severe postoperative complications was 119.5 Hounsfield unit (HU) and 39 patients (37.9%) were diagnosed with osteopenia. The univariate analysis revealed that the American Society of Anesthesiologists Physical Status of ≥3 (P = .0084), hemoglobin levels (P = .0026), albumin levels (P < .001), sarcopenia (P = .015), and osteopenia (P < .001) were significantly associated with severe postoperative complications. The multivariate analysis showed that osteopenia (P = .014) was an independent risk factor for severe postoperative complications. Conclusion Osteopenia may be a risk factor for severe postoperative complications in elderly patients after emergency gastrointestinal surgery.

The role of geriatric nutritional risk index as a predictor for postoperative outcomes in gastrointestinal emergencies

“…Patients who underwent reoperations were excluded. Among them, 103 patients have been studied previously 4 . Patient data included age, sex, BMI, comorbidities (diabetes mellitus and cardiac disease), antithrombotic agent status, blood cell counts, and biochemical blood test.…”

“…Among them, 103 patients have been studied previously. 4 Patient data included age, sex, BMI, comorbidities (diabetes mellitus and cardiac disease), antithrombotic agent status, blood cell counts, and biochemical blood test. Blood test data were collected within 48 h preoperatively.…”

“…As the population ages, over 20%–25% of the population will be aged 65 years or older by the year 2030–2035, and there will be a continued rise in the demand for emergency gastrointestinal surgeries among older adults 2,3 . Older adults are more likely to develop postoperative complications due to malnutrition, frailty, and sarcopenia than younger adults 4–6 . Therefore, assessing these factors in older adults undergoing emergency gastrointestinal surgery is crucial in an aging society.…”

“…than younger adults. [4][5][6] Therefore, assessing these factors in older adults undergoing emergency gastrointestinal surgery is crucial in an aging society.…”

Prognostic significance of osteosarcopenia in older adults with colorectal cancer

“…Osteopenia was de ned as BMD below the calculated standard BMD, which was calculated as previously reported (308.82-2.49 × age in men and 311.84-2.41 × age in women) [21]. BMD was measured using the average pixel density (Houns eld unit) within a circle in the midvertebral core at the bottom of the Th11 on the preoperative plain CT image, as previously described [22]. Osteosarcopenia was de ned as the coexistence of osteopenia and sarcopenia [8].…”