Sarcopenia discriminates poor prognosis in elderly patients following emergency surgery for perforation panperitonitis

Autor: Tokujiro Yano, Toshifumi Matsumoto, Eiji Oki, H. Kawanaka, Hirotada Tajiri, Shoji Hiroshige, Akinori Egashira, Hideya Takeuchi, Nobuhide Kubo
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Annals of Gastroenterological Surgery, Vol 3, Iss 6, Pp 630-637 (2019)
Annals of Gastroenterological Surgery
ISSN: 2475-0328
Popis: 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 (cm2) of skeletal muscle in the L3 region on computed tomography images normalized for height (cm2/m2). Sarcopenia was defined as an SMI of ≤43.75 and ≤41.10 cm2/m2 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%, P = .015) (20.0% vs 5.7%, P = .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
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 discriminate patients eligible or not eligible for emergency surgery among elderly patients.
Databáze: OpenAIRE
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