Premium
Sarcopenic obesity and post‐operative morbidity after pancreatic surgery: a cohort study
Author(s) -
Ratnayake Chathura B. B.,
Wells Cameron,
Olsson Magda,
Windsor John A.,
Pandanaboyana Sanjay
Publication year - 2019
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15431
Subject(s) - medicine , sarcopenia , skeletal muscle , cohort , odds ratio , sarcopenic obesity , body mass index , pancreaticoduodenectomy , surgery , cohort study , gastroenterology , pancreas
Background Several indices of sarcopenia (SARC) exist in the literature, however, there is no consensus as to the best SARC index to predict post‐operative morbidity following pancreatic surgery. Methods A prospectively collected database was reviewed in a single institution including a total of 89 consecutive patients who had undergone pancreatic resection between 2015 and 2018. Results A total of 89 patients comprised the cohort. Seventy‐one percent (63/89) underwent pancreaticoduodenectomy. SARC was identified in 49 patients (55%) using psoas muscle index, 44 patients (49%) using the skeletal muscle index and 25 patients (28%) using the skeletal muscle attenuation. Post‐operative morbidity did not differ between SARC and non‐SARC (NSARC) patients using all three preoperative computed tomography measures (skeletal muscle index SARC 64%, 28/44, NSARC 64%, 29/45, P = 1.000; psoas muscle index SARC 63%, 31/49, NSARC 65%, 26/40, P = 0.810; skeletal muscle attenuation SARC 17/25, NSARC 40/64, P = 0.247). However, sarcopenic obesity was a significant independent risk factor for overall post‐operative morbidity on multivariate analysis (odds ratio 1.241 (SE 0.608), P = 0.041) with the highest specificity (81%). Conclusion Preoperative sarcopenic obesity can be an important independent predictor of post‐operative morbidity following pancreatic resection. There remains a need for standardization of SARC indices.