Sarcopenia predicts postoperative infection in patients undergoing hepato-biliary-pancreatic surgery

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Abstract

Background Operative mortality and morbidity rates after hepato-biliary-pancreatic (BILI) surgery remain high. This study evaluated clinical characteristics and surgical outcomes of patients who underwent BILI surgery and investigated predictors of outcomes by focusing on sarcopenia. Materials and methods A prospective observational study was performed for consecutive patients who underwent BILI surgery at our institution between June 2013 and May 2014. Sarcopenia was evaluated using computed tomography. Surgical outcomes and the influence of sarcopenia on outcomes were evaluated. Subsequently, the impact of prognostic factors, including sarcopenia, associated with postoperative infections was assessed using multivariate analyses. Results Total mortality, major complications, and infectious disease rates for all 157 patients were 0%, 9.6%, and 21.7%, respectively. Thirty-eight patients met the criteria for sarcopenia. The sarcopenic group had a significantly higher incidence of infectious complications compared to the non-sarcopenic group (36.8% vs. 17.2%; P = 0.015). During multivariate analyses of prognostic factors, sarcopenia (hazard ratio = 2.44; P = 0.043) and diabetes mellitus (hazard ratio = 3.07; P = 0.01) were detected as independent predictors of postoperative infections. Conclusions Sarcopenia is an independent preoperative predictor of infection after BILI surgery. Earlier diagnosis and therapeutic intervention for patients with sarcopenia could be useful in the development of comprehensive approaches for perioperative care.

Original languageEnglish
Pages (from-to)12-18
Number of pages7
JournalInternational Journal of Surgery Open
Volume6
DOIs
Publication statusPublished - 2017

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Sarcopenia
Infection
Multivariate Analysis
Perioperative Care
Mortality
Observational Studies
Communicable Diseases
Early Diagnosis
Diabetes Mellitus
Tomography
Prospective Studies
Morbidity
Incidence

Keywords

  • Diabetes mellitus
  • Hepato-biliary-pancreatic surgery
  • Infection
  • Prospective study
  • Sarcopenia

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Sarcopenia predicts postoperative infection in patients undergoing hepato-biliary-pancreatic surgery",
abstract = "Background Operative mortality and morbidity rates after hepato-biliary-pancreatic (BILI) surgery remain high. This study evaluated clinical characteristics and surgical outcomes of patients who underwent BILI surgery and investigated predictors of outcomes by focusing on sarcopenia. Materials and methods A prospective observational study was performed for consecutive patients who underwent BILI surgery at our institution between June 2013 and May 2014. Sarcopenia was evaluated using computed tomography. Surgical outcomes and the influence of sarcopenia on outcomes were evaluated. Subsequently, the impact of prognostic factors, including sarcopenia, associated with postoperative infections was assessed using multivariate analyses. Results Total mortality, major complications, and infectious disease rates for all 157 patients were 0{\%}, 9.6{\%}, and 21.7{\%}, respectively. Thirty-eight patients met the criteria for sarcopenia. The sarcopenic group had a significantly higher incidence of infectious complications compared to the non-sarcopenic group (36.8{\%} vs. 17.2{\%}; P = 0.015). During multivariate analyses of prognostic factors, sarcopenia (hazard ratio = 2.44; P = 0.043) and diabetes mellitus (hazard ratio = 3.07; P = 0.01) were detected as independent predictors of postoperative infections. Conclusions Sarcopenia is an independent preoperative predictor of infection after BILI surgery. Earlier diagnosis and therapeutic intervention for patients with sarcopenia could be useful in the development of comprehensive approaches for perioperative care.",
keywords = "Diabetes mellitus, Hepato-biliary-pancreatic surgery, Infection, Prospective study, Sarcopenia",
author = "Kosei Takagi and Takahito Yagi and Ryuichi Yoshida and Yuzo Umeda and Daisuke Nobuoka and Takashi Kuise and Toshiyoshi Fujiwara",
year = "2017",
doi = "10.1016/j.ijso.2016.12.002",
language = "English",
volume = "6",
pages = "12--18",
journal = "International Journal of Surgery Open",
issn = "2405-8572",
publisher = "Elsevier Limited",

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TY - JOUR

T1 - Sarcopenia predicts postoperative infection in patients undergoing hepato-biliary-pancreatic surgery

AU - Takagi, Kosei

AU - Yagi, Takahito

AU - Yoshida, Ryuichi

AU - Umeda, Yuzo

AU - Nobuoka, Daisuke

AU - Kuise, Takashi

AU - Fujiwara, Toshiyoshi

PY - 2017

Y1 - 2017

N2 - Background Operative mortality and morbidity rates after hepato-biliary-pancreatic (BILI) surgery remain high. This study evaluated clinical characteristics and surgical outcomes of patients who underwent BILI surgery and investigated predictors of outcomes by focusing on sarcopenia. Materials and methods A prospective observational study was performed for consecutive patients who underwent BILI surgery at our institution between June 2013 and May 2014. Sarcopenia was evaluated using computed tomography. Surgical outcomes and the influence of sarcopenia on outcomes were evaluated. Subsequently, the impact of prognostic factors, including sarcopenia, associated with postoperative infections was assessed using multivariate analyses. Results Total mortality, major complications, and infectious disease rates for all 157 patients were 0%, 9.6%, and 21.7%, respectively. Thirty-eight patients met the criteria for sarcopenia. The sarcopenic group had a significantly higher incidence of infectious complications compared to the non-sarcopenic group (36.8% vs. 17.2%; P = 0.015). During multivariate analyses of prognostic factors, sarcopenia (hazard ratio = 2.44; P = 0.043) and diabetes mellitus (hazard ratio = 3.07; P = 0.01) were detected as independent predictors of postoperative infections. Conclusions Sarcopenia is an independent preoperative predictor of infection after BILI surgery. Earlier diagnosis and therapeutic intervention for patients with sarcopenia could be useful in the development of comprehensive approaches for perioperative care.

AB - Background Operative mortality and morbidity rates after hepato-biliary-pancreatic (BILI) surgery remain high. This study evaluated clinical characteristics and surgical outcomes of patients who underwent BILI surgery and investigated predictors of outcomes by focusing on sarcopenia. Materials and methods A prospective observational study was performed for consecutive patients who underwent BILI surgery at our institution between June 2013 and May 2014. Sarcopenia was evaluated using computed tomography. Surgical outcomes and the influence of sarcopenia on outcomes were evaluated. Subsequently, the impact of prognostic factors, including sarcopenia, associated with postoperative infections was assessed using multivariate analyses. Results Total mortality, major complications, and infectious disease rates for all 157 patients were 0%, 9.6%, and 21.7%, respectively. Thirty-eight patients met the criteria for sarcopenia. The sarcopenic group had a significantly higher incidence of infectious complications compared to the non-sarcopenic group (36.8% vs. 17.2%; P = 0.015). During multivariate analyses of prognostic factors, sarcopenia (hazard ratio = 2.44; P = 0.043) and diabetes mellitus (hazard ratio = 3.07; P = 0.01) were detected as independent predictors of postoperative infections. Conclusions Sarcopenia is an independent preoperative predictor of infection after BILI surgery. Earlier diagnosis and therapeutic intervention for patients with sarcopenia could be useful in the development of comprehensive approaches for perioperative care.

KW - Diabetes mellitus

KW - Hepato-biliary-pancreatic surgery

KW - Infection

KW - Prospective study

KW - Sarcopenia

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