General Surgery Residency Program, University of Kentucky, Lexington, KY, USA.
College of Medicine, University of Kentucky, Lexington, KY, USA.
Am Surg. 2023 Nov;89(11):4288-4296. doi: 10.1177/00031348221105561. Epub 2022 Jun 6.
Physical fitness is an important prognostic indicator for surgical outcomes. An objective measure of deconditioning is needed to determine patient fitness. This study aims to describe a methodology to standardize psoas measurements and correlate them with postoperative outcomes.
After obtaining IRB approval, the ACS-NSQIP database was queried for patients over 18 years, undergoing colectomies for non-trauma indications from 1/1/2013 to 12/31/2018. Upon CT imaging, the psoas muscle was identified at the lumbosacral joint. Imaging software calculated the total cross-sectional area of the left and right psoas muscle and was normalized by dividing by height squared to achieve our Total Psoas Index (TPI) in cm/m.
1173 patients met study criteria; all had TPI calculated. A TPI equal to or below the gender-specific 25th percentile defined sarcopenia. In total, 151 females (24.6%) and 137 males (24.5%) were classified as sarcopenic. TPI was significantly associated with multiple NSQIP 30-day outcomes and mortality in our study population.
Measuring TPI at the lumbosacral joint is an appropriate method for determining sarcopenia.
体能是手术结果的一个重要预后指标。需要一种客观的去适应不良的衡量标准来确定患者的健康状况。本研究旨在描述一种标准化竖脊肌测量的方法，并将其与术后结果相关联。
在获得机构审查委员会批准后，从 2013 年 1 月 1 日至 2018 年 12 月 31 日，查询 ACS-NSQIP 数据库中年龄超过 18 岁、因非创伤原因接受结肠切除术的患者。在 CT 成像时，在腰骶关节处识别竖脊肌。成像软件计算左、右竖脊肌的总横截面积，并通过除以身高的平方来标准化，以获得我们的总竖脊肌指数（TPI），单位为 cm/m。
符合研究标准的 1173 名患者均计算了 TPI。TPI 等于或低于性别特异性第 25 百分位数定义为肌肉减少症。总共 151 名女性（24.6%）和 137 名男性（24.5%）被归类为肌肉减少症。在我们的研究人群中，TPI 与多个 NSQIP 30 天结局和死亡率显著相关。
在腰骶关节处测量 TPI 是确定肌肉减少症的一种合适方法。
