Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy

• Published in: BMC surgery Vol. 17; no. 1; p. 64
• Main Authors: Takagi, Kosei, Yoshida, Ryuichi, Yagi, Takahito, Umeda, Yuzo, Nobuoka, Daisuke, Kuise, Takashi, Fujiwara, Toshiyoshi
• Format: Journal Article
• Language: English
• Published: England BioMed Central 26.05.2017; BMC
• Subjects: Abdomen; Aged; Aging; Antibiotics; Blood; Complication; Complications; Computed tomography; Criteria; Depletion; Female; Frailty; Hospital Mortality; Hospitals; Humans; Impact analysis; Incidence; Infection; Infections; Infectious diseases; Male; Management; Middle Aged; Morbidity; Mortality; Multivariate analysis; Muscle, Skeletal - pathology; Musculoskeletal system; Older people; Pancreas; Pancreas transplantation; Pancreaticoduodenectomy; Pancreaticoduodenectomy - adverse effects; Patients; Postoperative Complications - epidemiology; Postoperative period; Retrospective Studies; Risk assessment; Risk Factors; Risk management; Sarcopenia; Sarcopenia - diagnostic imaging; Short term; Skeletal muscle; Skeleton; Surface layers; Surgeons; Surgery; Surgical outcomes; Surgical Wound Infection - epidemiology; Texture; Tomography, X-Ray Computed; Japan; Infection; Sarcopenia; Complication; Pancreaticoduodenectomy
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-017-0261-7

Recently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative outcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes following pancreaticoduodenectomy (PD). We performed a retrospective study of consecutive patients (n = 219) who underwent PD at our institution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed tomography. We evaluated postoperative outcomes and the influence of sarcopenia on short-term outcomes, especially infectious complications. Subsequently, multivariate analysis was used to assess the impact of prognostic factors (including sarcopenia) on postoperative infections. The mortality, major complication, and infectious complication rates for all patients were 1.4%, 16.4%, and 47.0%, respectively. Fifty-five patients met the criteria for sarcopenia. Sarcopenia was significantly associated with a higher incidence of in-hospital mortality (P = 0.004) and infectious complications (P < 0.001). In multivariate analyses, sarcopenia (odds ratio = 3.43; P < 0.001), preoperative biliary drainage (odds ratio = 2.20; P = 0.014), blood loss (odds ratio = 1.92; P = 0.048), and soft pancreatic texture (odds ratio = 3.71; P < 0.001) were independent predictors of postoperative infections. Sarcopenia is an independent preoperative predictor of infectious complications after PD. Clinical assessment combined with sarcopenia may be helpful for understanding the risk of postoperative outcomes and determining perioperative management strategies.