Visceral fat area, not body mass index, predicts postoperative 30-day morbidity in patients undergoing colon resection for cancer

Kuritzkes, Benjamin; Pappou, Emmanouil P.; Kiran, Ravi P.; Başer, Onur; Fan, Liqiong; Guo, X. Edward; Zhao, Binsheng; Bentley–Hibbert, Stuart

doi:10.1007/s00384-018-3038-2

Cited by 38 publications

(25 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PMI is a simple but reliable method of prognostic evaluation similar to SOFA. Body composition has recently been reported as a risk factor or prognostic factor for postoperative complications [3,5,24,25]. In particular, skeletal muscle mass is considered important [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

Kayano

Nomura

Abe

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Various body composition indices have been reported as prognostic factors for different cancers. However, whether body composition affects prognosis after lower gastrointestinal tract perforation requiring emergency surgery and multidisciplinary treatment has not been clarified. This study examined whether body composition evaluations that can be measured easily and quickly from computed tomography (CT) are useful for predicting prognosis. Methods Subjects comprised 64 patients diagnosed with perforation at final diagnosis after emergency surgery for a preoperative diagnosis of lower gastrointestinal tract perforation and penetration. They were divided into a survival group and a non-survival (in-hospital mortality) group and compared. Body composition indices (psoas muscle index (PMI); psoas muscle attenuation (PMA); subcutaneous adipose tissue index (SATI); visceral adipose tissue index (VATI); visceral-to-subcutaneous fat area ratio (VSR)) were measured from preoperative CT. Cross-sectional psoas muscle area at the level of the 3rd lumbar vertebra was quantified. Optimal cut-off values were calculated using receiver operating characteristic curve analysis. Poor prognostic factors were investigated from multivariate logistic regression analyses that included patient factors, perioperative factors, intraoperative factors, and body composition indices as explanatory variables. Results The cause of perforation was malignant disease in 12 cases (18.7%), and benign disease in 52 cases (81.2%). The most common cause was diverticulum of the large intestine. Emergency surgery for the 64 patients led to survival in 52 patients and death in 12 patients. On multivariate logistic regression analysis, independent predictors of poor prognosis were Sequential Organ Failure Assessment score (odds ratio 1.908; 95% confidence interval (CI) 1.235–3.681; P =0.0020) and PMI (odds ratio 13.478; 95%CI 1.342–332.690; P =0.0252). The cut-off PMI was 4.75 cm 2 /m 2 for males and 2.89 cm 2 /m 2 for females. Among survivors, duration of hospitalization was significantly longer in the low PMI group (29 days) than in the high PMI group (22 days, p=0.0257). Conclusions PMI is easily determined from CT and allows rapid evaluation of prognosis following lower gastrointestinal perforation.

show abstract

Section: Discussionmentioning

confidence: 99%

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

Kayano

Nomura

Abe

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Moreover, the use of preoperative CTA-derived measurements also appears promising in the field of vascular surgery, in which a specific measurement, namely, core muscle size, correlates with postoperative mortality [ 61 ]. Nonetheless, morphological measurements of fat tissue seem to have a high impact on risk assessment for postoperative donor-site complications in general surgery [ 16 , 17 , 62 ] and in abdominally-based breast reconstruction [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…The latest scientific knowledge suggests that the thus far mentioned complications occur due to a multitude of causes associated with various patient-specific traits [ 10 , 12 ] and objective morphology-based parameters [ 13 , 14 ]. Numerous recently-published studies have shown the potential of objective morphometric measurements in risk assessment for different types of surgery [ 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction

Meyer

Handschin

Boll

et al. 2020

JCM

View full text Add to dashboard Cite

Microsurgical abdominally-based reconstruction is considered the gold standard in autologous breast reconstruction. Despite refined surgical procedures, donor-site complications still occur, reducing patient satisfaction and quality of life. Recent work has outlined the potential of morphometric measurements in risk assessment for postoperative hernia development. With rising demand for personalised treatment, the goal of this study was to investigate their potential in risk assessment for any donor site complication. In this retrospective cohort study, 90 patients were included who each received microsurgical breast reconstruction at the hands of one surgeon between January 2015 and May 2017. Donor-site complications formed the primary outcome and were classified according to Clavien–Dindo. Morphometric measurements were taken on a routinely performed computed tomographic angiogram. Complications occurred in 13 of the 90 (14.4%) cases studied. All patients who developed any type of postoperative donor site complication had a history of abdominal surgery. The risk of postoperative complications increased by 3% with every square centimetre of omental fat tissue (OR 1.03, 95% CI 1.00–1.06, and p-value = 0.022). Morphometric measurements provide valuable information in risk assessment for donor-site complications in abdominally-based breast reconstruction. They may help identify personalised reconstructive options for maximal postoperative patient satisfaction and quality of life.

show abstract

“…Generally, visceral fat is a major factor in uencing the technical di culty during abdominal surgery. It has been shown in several studies [15][16][17] that obese patients are associated with a higher rate of complications such as wound infection, anastomotic stula, and longer hospital stay. Recently, it was reported that a high amount of visceral fat was associated with a signi cantly higher rate of overall complications and pancreatic stula development after PD 15,18 .…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the abdominal fat area-based risk score for postoperative pancreatic fistula after pancreatoduodenectomy

Endo

Kitago

Shinoda

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundPancreatic fistulas remain a significant concern after pancreatectomy, and it is not possible to perform preoperative risk stratification for all patients. This study aimed to evaluate the usefulness of a unique risk model, based on the abdominal fat area (AFA) calculated by computed tomography, for pancreatic fistula development after pancreatoduodenectomy and compare it with models based on the body mass index (BMI) or abdominal thickness.Material and Methods Patient characteristics, preoperative laboratory data, radiographic findings, and their association with pancreatic fistula development after pancreaticoduodenectomy were analysed for 158 patients who underwent resection between 2011 and 2017. Clinically relevant postoperative pancreatic fistulas (CR-POPF) were defined as Grade B or C fistulas based on the International Study Group of Pancreatic Surgery (ISGPS) 2016 consensus.ResultsCR-POPF developed in 38 patients (24.2%). Multivariate logistic analysis indicated that the AFA, BMI, and intra-abdominal thickness were potential candidates for predictive models for pancreatic fistula development, small pancreatic duct diameter, diabetes mellitus development, and the pathology of non-pancreatic cancers. When comparing the three risk models (AFA-, BMI-, and intra-abdominal thickness-based), the AFA-derived risk model was superior to the BMI-based and intra-abdominal thickness-based risk stratification models (area under the curve 0.836 vs 0.824 vs 0.826).Conclusions The risk model based on AFA calculation was superior to that based on BMI or intra-abdominal thickness measurements. The model must be validated further to elucidate the efficacy of the risk scoring system in more detail.

show abstract

Visceral fat area, not body mass index, predicts postoperative 30-day morbidity in patients undergoing colon resection for cancer

Abstract: VFA but not BMI predicts morbidity following elective surgery for colon cancer.

Cited by 38 publications

References 39 publications

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction

Usefulness of the abdominal fat area-based risk score for postoperative pancreatic fistula after pancreatoduodenectomy

Contact Info

Product

Resources

About