Mulinacci Giacomo, Conti Clara Benedetta, Savino Alberto, Gandola Davide, Ippolito Davide, Frego Roberto, Redaelli Alessandro Ettore, Maino Marta, Dinelli Marco Emilio
Interventional Endoscopy Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy.
Department of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy.
Life (Basel). 2024 Dec 28;15(1):21. doi: 10.3390/life15010021.
Despite technical advances, endoscopic retrograde cholangiopancreatography (ERCP) is associated with complications and potentially lethal outcomes. Sarcopenia, a complex syndrome mainly associated with aging, has been recognized as a predictor of poor surgical outcomes. Thus far, the impact of sarcopenia on ERCP remains unknown. The present study evaluates the role of sarcopenia as a predictor of ERCP-related outcomes in a cohort of elderly patients.
Patients who underwent ERCP between June 2019 and January 2023 were retrospectively included. Demographic and procedure-associated data were collected. Sarcopenia was assessed using the skeletal muscle index (SMI) measured from a single axial slice through the L3 vertebra on a CT scan. ERCP-related outcomes were recorded. Univariate and multivariate analyses were used to assess the correlation between sarcopenia and procedural outcomes.
In total, 256 patients were enrolled, of whom 30 (11.7%) were sarcopenic. Cardiopulmonary complications of ERCP occurred in 3.5%. Sarcopenia was associated with higher 30-day and 12-month post-ERCP mortality (OR 3.45, = 0.03; OR 3.87, = 0.004) and longer hospitalization time (7 vs. 11 days, = 0.003).
SMI is an easy and objective index of sarcopenia that could be used to predict ERCP outcomes. Indeed, sarcopenia was independently associated with prolonged hospitalization and increased mortality in a retrospective cohort of elderly patients.
尽管技术不断进步，但内镜逆行胰胆管造影术（ERCP）仍会引发并发症并可能导致致命后果。肌肉减少症是一种主要与衰老相关的复杂综合征，已被视为手术预后不良的预测指标。迄今为止，肌肉减少症对ERCP的影响尚不清楚。本研究评估了肌肉减少症在老年患者队列中作为ERCP相关预后预测指标的作用。
回顾性纳入2019年6月至2023年1月期间接受ERCP的患者。收集人口统计学和与手术相关的数据。使用CT扫描通过L3椎体的单个轴向切片测量的骨骼肌指数（SMI）评估肌肉减少症。记录ERCP相关的预后情况。采用单因素和多因素分析评估肌肉减少症与手术预后之间的相关性。
共纳入256例患者，其中30例（11.7%）存在肌肉减少症。ERCP的心肺并发症发生率为3.5%。肌肉减少症与ERCP后30天和12个月的较高死亡率相关（OR 3.45，P = 0.03；OR 3.87，P = 0.004），且住院时间更长（7天对11天，P = 0.003）。
SMI是一种简单且客观的肌肉减少症指标，可用于预测ERCP的预后。实际上，在一个老年患者回顾性队列中，肌肉减少症与住院时间延长和死亡率增加独立相关。
