Can Sarcopenia Quantified by Computer Tomography Scan Predict Adverse Outcomes in Emergency General Surgery?

Mohammad Hamidi, Cathy Ho, Muhammad Zeeshan, Terence S Okeeffe, Ali Hamza, Narong Kulvatunyou, Faisal Jehan, Bellal A Joseph

Research output: Contribution to journalArticle

Abstract

Background: Sarcopenia (a decline of skeletal muscle mass) has been identified as a predictor of poor postoperative outcomes. The impact of sarcopenia in emergency general surgery (EGS) remains undetermined. The aim of this study was to evaluate the association between sarcopenia and outcomes after EGS. Methods: A 3-y (2012-15) review of all EGS patients aged ≥45 y was presented to our institution. Patients who underwent computer tomography–abdomen were included. Sarcopenia was defined as the lowest sex-specific quartile of total psoas index (computer tomography–measured psoas area normalized for body surface area). Patients were divided into sarcopenic (SA) and nonsarcopenic. Primary outcome measures were in-hospital complications, hospital-length of stay [h-LOS], intensive care unit-length of stay, adverse discharge disposition, and in-hospital mortality. Our secondary outcome measures were 30-d complications, readmissions, and mortality. Results: Four hundred fifty-two patients undergoing EGS were included. Mean age was 58 ± 8.7 y, and 60% were males. Hundred thirteen patients were categorized as SA. Compared to nonsarcopenic, SA patients had higher rates of minor complications (28% versus 17%, P = 0.01), longer hospital-length of stay (7d versus 5d, P = 0.02), and were more likely to be discharged to skilled nursing facility/Rehab (35% versus 17%, P = 0.01). There was no difference between the two groups regarding major complications, intensive care unit-length of stay, mortality, and 30-d outcomes. On regression analysis, sarcopenia was an independent predictor of minor complications (OR 1.8 [1.6-3.7]) and discharge to rehab/SNIF (OR: 1.9 [1.5-3.2]). However, there was no association with major complications, mortality, 30-d complications, readmissions, and mortality. Conclusions: Sarcopenia is an independent predictor of minor postoperative complications, prolonged hospital-length of stay, and an adverse discharge disposition in patients undergoing EGS. Identifying SA EGS patients will improve both resource allocation and discussion about the patient's prognosis between physicians, patients, and their families.

LanguageEnglish (US)
Pages141-147
Number of pages7
JournalJournal of Surgical Research
Volume235
DOIs
StatePublished - Mar 1 2019

Fingerprint

Sarcopenia
Emergencies
Tomography
Length of Stay
Mortality
Intensive Care Units
Outcome Assessment (Health Care)
Skilled Nursing Facilities
Resource Allocation
Body Surface Area
Hospital Mortality
Abdomen
Skeletal Muscle
Regression Analysis

Keywords

  • Complications
  • CT scan
  • EGS
  • Sarcopenia

ASJC Scopus subject areas

  • Surgery

Cite this

Can Sarcopenia Quantified by Computer Tomography Scan Predict Adverse Outcomes in Emergency General Surgery? / Hamidi, Mohammad; Ho, Cathy; Zeeshan, Muhammad; Okeeffe, Terence S; Hamza, Ali; Kulvatunyou, Narong; Jehan, Faisal; Joseph, Bellal A.

In: Journal of Surgical Research, Vol. 235, 01.03.2019, p. 141-147.

Research output: Contribution to journalArticle

Hamidi, Mohammad ; Ho, Cathy ; Zeeshan, Muhammad ; Okeeffe, Terence S ; Hamza, Ali ; Kulvatunyou, Narong ; Jehan, Faisal ; Joseph, Bellal A. / Can Sarcopenia Quantified by Computer Tomography Scan Predict Adverse Outcomes in Emergency General Surgery?. In: Journal of Surgical Research. 2019 ; Vol. 235. pp. 141-147.
@article{b60d0937ea1f419791aee0d917dbbaa5,
title = "Can Sarcopenia Quantified by Computer Tomography Scan Predict Adverse Outcomes in Emergency General Surgery?",
abstract = "Background: Sarcopenia (a decline of skeletal muscle mass) has been identified as a predictor of poor postoperative outcomes. The impact of sarcopenia in emergency general surgery (EGS) remains undetermined. The aim of this study was to evaluate the association between sarcopenia and outcomes after EGS. Methods: A 3-y (2012-15) review of all EGS patients aged ≥45 y was presented to our institution. Patients who underwent computer tomography–abdomen were included. Sarcopenia was defined as the lowest sex-specific quartile of total psoas index (computer tomography–measured psoas area normalized for body surface area). Patients were divided into sarcopenic (SA) and nonsarcopenic. Primary outcome measures were in-hospital complications, hospital-length of stay [h-LOS], intensive care unit-length of stay, adverse discharge disposition, and in-hospital mortality. Our secondary outcome measures were 30-d complications, readmissions, and mortality. Results: Four hundred fifty-two patients undergoing EGS were included. Mean age was 58 ± 8.7 y, and 60{\%} were males. Hundred thirteen patients were categorized as SA. Compared to nonsarcopenic, SA patients had higher rates of minor complications (28{\%} versus 17{\%}, P = 0.01), longer hospital-length of stay (7d versus 5d, P = 0.02), and were more likely to be discharged to skilled nursing facility/Rehab (35{\%} versus 17{\%}, P = 0.01). There was no difference between the two groups regarding major complications, intensive care unit-length of stay, mortality, and 30-d outcomes. On regression analysis, sarcopenia was an independent predictor of minor complications (OR 1.8 [1.6-3.7]) and discharge to rehab/SNIF (OR: 1.9 [1.5-3.2]). However, there was no association with major complications, mortality, 30-d complications, readmissions, and mortality. Conclusions: Sarcopenia is an independent predictor of minor postoperative complications, prolonged hospital-length of stay, and an adverse discharge disposition in patients undergoing EGS. Identifying SA EGS patients will improve both resource allocation and discussion about the patient's prognosis between physicians, patients, and their families.",
keywords = "Complications, CT scan, EGS, Sarcopenia",
author = "Mohammad Hamidi and Cathy Ho and Muhammad Zeeshan and Okeeffe, {Terence S} and Ali Hamza and Narong Kulvatunyou and Faisal Jehan and Joseph, {Bellal A}",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.jss.2018.09.027",
language = "English (US)",
volume = "235",
pages = "141--147",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Can Sarcopenia Quantified by Computer Tomography Scan Predict Adverse Outcomes in Emergency General Surgery?

AU - Hamidi, Mohammad

AU - Ho, Cathy

AU - Zeeshan, Muhammad

AU - Okeeffe, Terence S

AU - Hamza, Ali

AU - Kulvatunyou, Narong

AU - Jehan, Faisal

AU - Joseph, Bellal A

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Sarcopenia (a decline of skeletal muscle mass) has been identified as a predictor of poor postoperative outcomes. The impact of sarcopenia in emergency general surgery (EGS) remains undetermined. The aim of this study was to evaluate the association between sarcopenia and outcomes after EGS. Methods: A 3-y (2012-15) review of all EGS patients aged ≥45 y was presented to our institution. Patients who underwent computer tomography–abdomen were included. Sarcopenia was defined as the lowest sex-specific quartile of total psoas index (computer tomography–measured psoas area normalized for body surface area). Patients were divided into sarcopenic (SA) and nonsarcopenic. Primary outcome measures were in-hospital complications, hospital-length of stay [h-LOS], intensive care unit-length of stay, adverse discharge disposition, and in-hospital mortality. Our secondary outcome measures were 30-d complications, readmissions, and mortality. Results: Four hundred fifty-two patients undergoing EGS were included. Mean age was 58 ± 8.7 y, and 60% were males. Hundred thirteen patients were categorized as SA. Compared to nonsarcopenic, SA patients had higher rates of minor complications (28% versus 17%, P = 0.01), longer hospital-length of stay (7d versus 5d, P = 0.02), and were more likely to be discharged to skilled nursing facility/Rehab (35% versus 17%, P = 0.01). There was no difference between the two groups regarding major complications, intensive care unit-length of stay, mortality, and 30-d outcomes. On regression analysis, sarcopenia was an independent predictor of minor complications (OR 1.8 [1.6-3.7]) and discharge to rehab/SNIF (OR: 1.9 [1.5-3.2]). However, there was no association with major complications, mortality, 30-d complications, readmissions, and mortality. Conclusions: Sarcopenia is an independent predictor of minor postoperative complications, prolonged hospital-length of stay, and an adverse discharge disposition in patients undergoing EGS. Identifying SA EGS patients will improve both resource allocation and discussion about the patient's prognosis between physicians, patients, and their families.

AB - Background: Sarcopenia (a decline of skeletal muscle mass) has been identified as a predictor of poor postoperative outcomes. The impact of sarcopenia in emergency general surgery (EGS) remains undetermined. The aim of this study was to evaluate the association between sarcopenia and outcomes after EGS. Methods: A 3-y (2012-15) review of all EGS patients aged ≥45 y was presented to our institution. Patients who underwent computer tomography–abdomen were included. Sarcopenia was defined as the lowest sex-specific quartile of total psoas index (computer tomography–measured psoas area normalized for body surface area). Patients were divided into sarcopenic (SA) and nonsarcopenic. Primary outcome measures were in-hospital complications, hospital-length of stay [h-LOS], intensive care unit-length of stay, adverse discharge disposition, and in-hospital mortality. Our secondary outcome measures were 30-d complications, readmissions, and mortality. Results: Four hundred fifty-two patients undergoing EGS were included. Mean age was 58 ± 8.7 y, and 60% were males. Hundred thirteen patients were categorized as SA. Compared to nonsarcopenic, SA patients had higher rates of minor complications (28% versus 17%, P = 0.01), longer hospital-length of stay (7d versus 5d, P = 0.02), and were more likely to be discharged to skilled nursing facility/Rehab (35% versus 17%, P = 0.01). There was no difference between the two groups regarding major complications, intensive care unit-length of stay, mortality, and 30-d outcomes. On regression analysis, sarcopenia was an independent predictor of minor complications (OR 1.8 [1.6-3.7]) and discharge to rehab/SNIF (OR: 1.9 [1.5-3.2]). However, there was no association with major complications, mortality, 30-d complications, readmissions, and mortality. Conclusions: Sarcopenia is an independent predictor of minor postoperative complications, prolonged hospital-length of stay, and an adverse discharge disposition in patients undergoing EGS. Identifying SA EGS patients will improve both resource allocation and discussion about the patient's prognosis between physicians, patients, and their families.

KW - Complications

KW - CT scan

KW - EGS

KW - Sarcopenia

UR - http://www.scopus.com/inward/record.url?scp=85055458640&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055458640&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2018.09.027

DO - 10.1016/j.jss.2018.09.027

M3 - Article

VL - 235

SP - 141

EP - 147

JO - Journal of Surgical Research

T2 - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

ER -