Key result
Male sex, low skeletal muscle mass, and arteriosclerosis (CAVI ≥ 10) were identified as significant independent risk factors for developing Grade ≥ III postoperative complications.
Why the study?
Predicting postoperative complications in elderly patients undergoing gastrointestinal surgery is challenging due to the lack of a reliable preoperative evaluation system.
Do male sex, low skeletal muscle mass, and arteriosclerosis predict postoperative complications in elderly patients undergoing elective gastrointestinal surgery?
Cohort (n=189)
No
Do male sex, low skeletal muscle mass, and arteriosclerosis predict postoperative complications in elderly patients undergoing elective gastrointestinal surgery?
Male sex, low skeletal muscle mass, and arteriosclerosis (CAVI ≥ 10) are independent predictors of severe postoperative complications in elderly patients undergoing elective gastrointestinal surgery.
Low skeletal muscle mass and arteriosclerosis may flag high-risk elderly GI surgery patients; leaves open validation before routine preoperative adoption.
BACKGROUND: Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group. METHODS: This prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien-Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods. RESULTS: Clavien-Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications. CONCLUSIONS: Male sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management.
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Yokozuka et al. (2021) conducted a cohort in Elective gastrointestinal surgery (n=189). Arteriosclerosis (CAVI ≥ 10) vs. Absence of arteriosclerosis (CAVI < 10) was evaluated on Clavien-Dindo Grade ≥ III postoperative complications (OR 2.81, 95% CI 1.18-6.67, p=0.019). Male sex, low skeletal muscle mass, and arteriosclerosis (CAVI ≥ 10) were identified as significant independent risk factors for developing Grade ≥ III postoperative complications.
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