Reisinger KW, van Vugt JL, Tegels JJ, et al.
Ann Surg 2015;261:345-52
Publication date: February 1, 2015
This study was aimed at determining the association of sarcopenia with postoperative morbidity and mortality after colorectal surgery. A total of 310 consecutive patients who underwent oncologic colorectal surgery were included in a prospective digital database. Sarcopenia was assessed using the L3 muscle index utilizing Osirix on preoperative computed tomography, and Groningen Frailty Indicator and Short Nutritional Assessment Questionnaire scores were used to assess frailty and nutritional compromise.
Age was an independent predictor of mortality. Thirty-day/in-hospital mortality rate in sarcopenic patients was 8.8% versus 0.7% in nonsarcopenic patients (P=0.001; odds ratio, 15.5; 95% CI, 2.00-120). Sarcopenia was not predictive for anastomotic leakage or sepsis. Combination of high Short Nutritional Assessment Questionnaire score, high Groningen Frailty Indicator score, and sarcopenia strongly predicted sepsis (P=0.001; odds ratio, 25.1; 95% CI, 5.11-123).
In conclusion, functional compromise in colorectal cancer surgery is associated with adverse postoperative outcome.