Purpose
Patients with Crohn’s disease (CD) have a high likelihood of being sarcopenic [1]. Several studies have shown a positive correlation between sarcopenia measured as skeletal muscle index (SMI) and poor surgical outcomes in patients with CD. In mixed IBD cohorts, sarcopenia was associated with postoperative infection complications, intensive care unit (ICU) admission, anastomotic leaks and requirement for total parenteral nutrition (TPN) [1-3]. However, a recent meta-analysis showed significant heterogeneity among studies related to IBD [4]. The meta-analysis also showed that in a subgroup analysis of...
Methods and materials
We performed a retrospective cohort study of CD patients who underwent surgery at a public health service from January 2010 to December 2019. Using computed tomography and magnetic resonance enterography studies, skeletal muscle area was measured at the third lumbar vertebra level. Images from CT studies were downloaded for each patient and total muscle and psoas muscle areas were measured using a semi-automated web-based free tool (CoreSlicer.com). [Fig 1] Images from MRE studies were measured using the freehand area measurement tool on the radiology viewer...
Results
Seventy-six patients were included (median age 45 years; IQR, 29.75–59; males 43, 56.6%). Twenty-six patients (34.2%) underwent emergency surgery with 38 (50%) laparoscopic, 35 (46%) open and 3 (4%) combined approaches. Median length of stay (LOS) was 6 days (IQR, 5 to 9, range 3 to 42). Eleven patients (14.5%) required ICU admission, nine patients (11.8%) required TPN and thirteen patients (17.1%) had complications. There were no deaths in our cohort. Further details are summarized in Table 1. [Fig 2] Operations performed are outlined in...
Conclusion
In summary, SMI and PMI show good correlation but there is insufficient evidence to suggest that sarcopenia status using either measurement has a significant impact on predicting clinical outcomes, even when contributions from other variables are accounted for.
Personal information
J. Hong:
Nothing to disclose
A. T. Tran:
Nothing to disclose
S. James:
Nothing to disclose
N. Kutaiba:
Nothing to disclose
References
[1] Trinder, M. W., Clifford, M., Jones, A. L., Shepherd, T., & Jacob, A. O. (2022). The impact of sarcopenia on outcomes in patients with inflammatory bowel disease undergoing colorectal surgery.ANZ Journal of Surgery,92(3), 397-402.
[2] Berger, M., Yamada, A., Komaki, Y., Komaki, F., Cohen, R. D., Dalal, S., ... & Micic, D. (2020). Low skeletal muscle index adjusted for body mass index is an independent risk factor for inflammatory bowel disease surgical complications.Crohn's & Colitis 360,2(3), otaa064.
[3] Pedersen, M., Cromwell, J., & Nau,...