The impact of sarcopenia and myosteatosis on postoperative outcomes in patients with inflammatory bowel disease

Stephen O'Brien; Richard G Kavanagh; Brian W Carey; Michael M Maher; Owen J O'Connor; Emmet J Andrews

doi:10.1186/s41747-018-0072-3

The impact of sarcopenia and myosteatosis on postoperative outcomes in patients with inflammatory bowel disease

Eur Radiol Exp. 2018 Nov 21;2(1):37. doi: 10.1186/s41747-018-0072-3.

Authors

Stephen O'Brien^{1

2}, Richard G Kavanagh³, Brian W Carey⁴, Michael M Maher^{3

5}, Owen J O'Connor^{3

5}, Emmet J Andrews²

Affiliations

¹ The Hiram C. Polk Jr., MD Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY, USA.
² Department of Surgery, Cork University Hospital, Cork, Ireland.
³ Department of Radiology, Cork University Hospital, Cork, Ireland.
⁴ Department of Radiology, Cork University Hospital, Cork, Ireland. brian_carey@ucc.ie.
⁵ Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland.

Abstract

Background: Inflammatory bowel disease (IBD) is a relatively common disorder with significant associated morbidity. Sarcopenia and myosteatosis are associated with adverse postoperative outcomes. This study investigated outcomes in IBD patients undergoing surgical resection relative to the presence of sarcopenia and myosteatosis.

Methods: A retrospective analysis of a prospectively maintained surgical database was conducted. All patients undergoing elective or emergency resection for IBD between 2011 and 2016, with a contemporaneous perioperative computed tomography (CT) scan, were included. Patient demographics, clinical and biochemical measurements were collected. Skeletal muscle index and attenuation were measured on perioperative CT scans using Osirix version 5.6.1. Univariate and multivariate regression analysis was used to identify risk factors for adverse postoperative outcomes.

Results: Seventy-seven patients (46 male, 31 female; mean age 42 years, range 20-80 years) were included. Thirty patients (30%) had sarcopenia and 26 (34%) had myosteatosis. Myosteatosis was significantly associated with increased hospital stay postoperatively (9 versus 13 days). Sarcopenia and myosteatosis were associated with hospital readmission within 30 days on univariate analysis. Multivariate regression analysis demonstrated an independent association between myosteatosis and hospital readmission. Sixteen patients (21%) had a clinically relevant postoperative complication, but an association with sarcopenia and myosteatosis was not observed. A neutrophil-lymphocyte ratio greater than 5 was predictive of clinically relevant postoperative complications on multivariate regression analysis.

Conclusions: Myosteatosis was associated with increased hospital stay and increased 30-day hospital readmission rates on multivariate regression analysis. Sarcopenia and myosteatosis in IBD were not associated with clinically relevant postoperative complications.

Keywords: Inflammatory bowel diseases; Length of stay; Morbidity; Muscle (skeletal); Sarcopenia; Tomography (x-ray; computed).