The University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Inflamm Bowel Dis. 2017 Oct;23(10):1867-1872. doi: 10.1097/MIB.0000000000001166.
Sarcopenia is associated with an increased risk of operative morbidity and mortality. The impact of sarcopenia in inflammatory bowel disease (IBD) has not been evaluated. This study assessed the role of sarcopenia on operative outcomes in IBD.
A retrospective review of American College of Surgeons National Surgical Quality Improvement Program data of patients with IBD was completed. Records were abstracted for comorbidities and perioperative complications. The Hounsfield unit average calculation was used from preoperative computed tomography (CT). Criteria for sarcopenia were based on the lowest 25th percentile. Complications were graded using the Clavien-Dindo classification system. Statistical analysis was completed using SAS.
There were 178 patients included. Sarcopenic patients were more likely to be older (P = 0.001), have hypertension (odds ratio = 2.23), and be diabetic (5.27). In those patients younger than 40 years, sarcopenia was an independent predictor of complications. This subset was significantly more likely to have a normal or elevated body mass index.
In this population, the average age of sarcopenic patients is increased from those who do not meet criteria. Among patients younger than 40 years, sarcopenia affects surgical outcomes. Assessment of sarcopenia can be used to improve preoperative management and describe risks before surgery in patients with IBD.
肌少症与手术发病率和死亡率增加相关。肌少症对炎症性肠病（IBD）的影响尚未得到评估。本研究评估了肌少症对 IBD 手术结果的影响。
对美国外科医师学会国家手术质量改进计划中 IBD 患者的回顾性研究数据进行了评估。对合并症和围手术期并发症进行了记录。使用术前计算机断层扫描（CT）的平均 Hounsfield 单位计算来评估肌少症。肌少症的标准基于最低的 25%百分位数。并发症的分级采用 Clavien-Dindo 分类系统。统计分析使用 SAS 完成。
共纳入 178 例患者。肌少症患者更可能年龄较大（P=0.001），患有高血压（优势比=2.23）和糖尿病（5.27）。在 40 岁以下的患者中，肌少症是并发症的独立预测因素。这组患者的身体质量指数更可能正常或升高。
在该人群中，符合肌少症标准患者的平均年龄大于不符合标准的患者。在 40 岁以下的患者中，肌少症会影响手术结果。评估肌少症可用于改善术前管理，并在 IBD 患者手术前描述风险。
