Aim: Sarcopenia has been reported as a prognostic predictor in various conditions; however, it has not been examined in patients with perforation panperitonitis.
Methods: A total of 103 consecutive patients with perforation panperitonitis who underwent emergency surgery from 2008 to 2016 were retrospectively evaluated. Skeletal muscle index (SMI) was measured as the cross-sectional area (cm) of skeletal muscle in the L3 region on computed tomography images normalized for height (cm/m). Sarcopenia was defined as an SMI of ≤43.75 and ≤41.10 cm/m in men and women, respectively. The impact of sarcopenia on postoperative outcomes was investigated.
Results: Sarcopenia was present in 50 (48.5%) patients. Severe complications (Clavien-Dindo grade ≥IIIb) and in-hospital mortality were more frequently observed in patients with than without sarcopenia (28.0% vs 9.4%, = .015) (20.0% vs 5.7%, = .029) respectively. Multivariate analysis showed that age, sarcopenia, and renal dysfunction were independent risk factors for severe complications and in-hospital mortality. The optimal cut-off levels of age and SMI for predicting these were ≥79 years and SMI <38 cm/m, respectively. Among the patients aged ≥79 years, those with SMI <38 cm/m had a severe complication rate of 71% and an in-hospital mortality rate of 57%, whereas the rate of those with SMI ≥38 cm/m was 22% ( = .011) and 11% ( = .008), respectively.
Conclusion: Sarcopenia is a predictive factor of severe complications and in-hospital mortality following emergency surgery for perforation panperitonitis, especially in elderly patients. Estimation of sarcopenia may identify patients eligible or not eligible for emergency surgery among elderly patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875939 | PMC |
| http://dx.doi.org/10.1002/ags3.12281 | DOI Listing |
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