Sarcopenia increased 30-day mortality risk by 2.56 times and myosteatosis by 4.26 times in emergency laparotomy patients, with both predicting higher morbidity rates.
Does the presence of sarcopenia or myosteatosis predict adverse outcomes in patients undergoing emergency laparotomy?
Sarcopenia and myosteatosis identified on preoperative CT are associated with increased risk of morbidity and mortality in emergency laparotomy patients.
Absolute Event Rate: 0% vs 0%
Objective: To determine the relationship between BC, specifically low skeletal muscle mass (sarcopenia) and poor muscle quality (myosteatosis) and outcomes in emergency laparotomy patients. Background: Emergency laparotomy has one of the highest morbidity and mortality rates of all surgical interventions. BC objectively identifies patients at risk of adverse outcomes in elective cancer cohorts, however, evidence is lacking in emergency surgery. Methods: An observational cohort study of patients undergoing emergency laparotomy at ten English hospitals was performed. BC analyses were performed at the third lumbar vertebrae level using preoperative computed tomography images to quantify skeletal muscle index (SMI) and skeletal muscle radiation attenuation (SM-RA). Sex-specific SMI and SM-RA were determined, with the lower tertile splits defining sarcopenia (low SMI) and myosteatosis (low SM-RA). Accuracy of mortality risk prediction, incorporating SMI and SM-RA variables into risk models was assessed with regression modeling. Results: Six hundred ten patients were included. Sarcopenia and myosteatosis were both associated with increased risk of morbidity (52.1% vs 45.1%, P = 0.028; 57.5% vs 42.6%, P = 0.014), 30-day (9.5% vs 3.6%, P = 0.010; 14.9% vs 3.4%, P < 0.001), and 1-year mortality (27.4% vs 11.5%, P < 0.001; 29.7% vs 12.5%, P < 0.001). Risk-adjusted 30-day mortality was significantly increased by sarcopenia OR 2.56 (95% CI 1.12-5.84), P = 0.026 and myosteatosis OR 4.26 (2.01-9.06), P < 0.001, similarly at 1-year OR 2.66 (95% CI 1.57-4.52), P < 0.001; OR2.08 (95%CI 1.26-3.41), P = 0.004. BC data increased discrimination of an existing mortality risk-prediction model (AUC 0.838, 95% CI 0.835–0.84). Conclusion: Sarcopenia and myosteatosis are associated with increased adverse outcomes in emergency laparotomy patients.
Body et al. (Thu,) reported a other. Sarcopenia increased 30-day mortality risk by 2.56 times and myosteatosis by 4.26 times in emergency laparotomy patients, with both predicting higher morbidity rates.