J.Y.YEO1, Y.Z LEE1, D.J.K LEE1, K.Y TAN1
Khoo Teck Puat Hospital1
Sarcopenia is associated with poorer post-operative recovery. A quick measurement of skeletal muscle index (SMI) at L3 level on computed tomography (CT), which is often performed in emergencies, can indicate sarcopenia. However, SMI cut-off for sarcopenia differs with populations. In our study, we aim to derive a cut-off value for our local population and correlate with post-operative outcomes.
Data from Khoo Teck Puat Hospital’s emergency laparotomy database was retrieved between 2016 – 2019. A retrospective analysis was done on patients aged >65-year-old. Data collected included SMI on CT, length of stay, complications and mortality. SMI was determined based on 25th percentile values and correlation with previous population studies. The cut-off values were determined as < 22.9 cm2/m for females and < 37.4 cm2/m2 for males.
289 patients were included for analysis. With the above values, 17% of our patients were sarcopenic.
In this group, the length of stay (20.8 vs 16.2 p-value 0.041), rate of Clavien–Dino IV complications (18.4% vs 7.5% p-value 0.035) and 1-year mortality (28.6% vs 14.6%, p-value 0.03) were higher. Further multivariate analysis showed that sarcopenic patients were twice as likely to demise within a year. (OR 2.35, 95% CI 1.15 – 4.8)
We identified SMI cut-off values which is predictive for poorer outcome. There is huge potential in using SMI to counsel and prognosticate outcomes, due to accessibility to CT and ease of calculation. This can improve clinical practice, resource allocation, and can be used with current risk prediction models.