Rinaldi John M, Geletzke Abby K, Phillips Brett E, Miller Jamie, Dykes Thomas M, Soybel David I
Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Department of Radiology, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Am J Surg. 2016 Nov;212(5):903-911. doi: 10.1016/j.amjsurg.2016.03.003. Epub 2016 Jun 1.
Chronic muscle wasting, or sarcopenia, has been associated with poor-health outcomes after major surgical procedures. Here, we explore the utility of CT-generated determinations of sarcopenia as markers of risk in patients undergoing evaluation for complex ventral hernia repair.
In 148 successive patients being evaluated for complex ventral hernia repair, CT scans were analyzed retrospectively for attributes of the hernia and indices of core-muscle mass, correlating them with preoperative clinical/laboratory profiles and outcomes in 82 patients who had undergone surgery.
Prevalence of sarcopenia, and sarcopenia corrected for obesity, was 26% and 20% respectively. Sarcopenia was associated with age, some laboratory indicators, and increased hospital length of stay but not with a higher likelihood of surgical site occurrence.
Obesity may obscure the value of sarcopenia as a marker of metabolic disturbance and postoperative outcome. Image-based measurements of core-muscle mass should be used with caution as predictors of risk in similar surgical populations.
慢性肌肉萎缩，即肌肉减少症，与重大外科手术后的不良健康结局相关。在此，我们探讨通过CT测定肌肉减少症作为接受复杂腹疝修补术评估患者风险标志物的效用。
对连续148例接受复杂腹疝修补术评估的患者，回顾性分析其CT扫描结果，以了解疝的特征和核心肌肉质量指数，并将其与82例已接受手术患者的术前临床/实验室资料及结局进行关联分析。
肌肉减少症及校正肥胖后的肌肉减少症患病率分别为26%和20%。肌肉减少症与年龄、一些实验室指标及住院时间延长相关，但与手术部位感染的较高可能性无关。
肥胖可能掩盖肌肉减少症作为代谢紊乱和术后结局标志物的价值。在类似手术人群中，基于图像的核心肌肉质量测量作为风险预测指标应谨慎使用。
