Sarcopenia and survival in patients undergoing pancreatic resection
| Autor: | Mark T. Tierney, Alan T. Davis, G. Paul Wright, Jill K. Onesti, Michael G. Doherty, Sarah E. Kenning, Mathew H. Chung |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Sarcopenia Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment 030230 surgery 03 medical and health sciences Young Adult 0302 clinical medicine Pancreatectomy Postoperative Complications Weight loss Risk Factors Internal medicine medicine Clinical endpoint Humans In patient Pancreatic resection Pancreas Aged Aged 80 and over Hepatology business.industry Gastroenterology Pancreatic Diseases Middle Aged medicine.disease Surgery 030220 oncology & carcinogenesis Adenocarcinoma Female medicine.symptom Complication business |
| Zdroj: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]. 16(2) |
| ISSN: | 1424-3911 |
| Popis: | Background Recent studies have suggested that lean core muscle area may predict outcomes from major abdominal surgeries. Pancreatic resections have been independently analyzed less frequently. Methods Pancreatic resections from 2005 to 2012 were reviewed. Sarcopenia was defined as the lowest tertile for lean psoas muscle area (LPMA). Preoperative risk factors, including comorbidities, albumin, weight loss, age and gender, were analyzed with a primary endpoint of overall survival. Secondary endpoints included complications, discharge destination and readmission. Results The study sample of 270 patients had complications in 42% of patients, with 26% developing serious complication. The majority (80%) were discharged home, and 1.9% died in the peri-operative period. The mean length of follow up was 31.2 months (range 0–94), and 37% required at least one readmission. LPMA was predictive of discharge destination for females (p = 0.038). Sarcopenia was predictive of readmission in males, compared to subjects in the second LPMA tertile (HR 0.3; 95% CI: 0.1–0.9). In all male subjects, including a subset with adenocarcinoma, patients with sarcopenia were more likely to die than males in the highest LPMA tertile (HR: 2.6; 95% CI: 1.4–4.8 and HR: 2.4; 95% CI: 1.2–4.9, respectively). In all patients with pancreatic ductal adenocarcinoma, transfusion (HR: 1.9; 95% CI: 1.1–3.4) and positive margins (HR: 2.0; 95% CI: 1.2–3.3) were the only factors predictive of overall survival. Conclusions Sarcopenia appears to be a predictor of overall survival in male patients undergoing pancreatic resections, but not specifically for patients with pancreatic ductal adenocarcinoma. As prospective data in future studies are identified, sarcopenia may become a useful tool in predicting outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect