Content-Length: 35984 | pFad | http://www.ncbi.nlm.nih.gov/pubmed/22871883

ear Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery

Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery

Br J Cancer. 2012 Sep 4;107(6):931-6. doi: 10.1038/bjc.2012.350. Epub 2012 Aug 7.

Abstract

Background: Skeletal muscle depletion (sarcopenia) predicts morbidity and mortality in the elderly and cancer patients.

Methods: We tested whether sarcopenia predicts primary colorectal cancer resection outcomes in stage II-IV patients (n=234). Sarcopenia was assessed using preoperative computed tomography images. Administrative hospitalisation data encompassing the index surgical admission, direct transfers for inpatient rehabilitation care and hospital re-admissions within 30 days was searched for International Classification of Disease (ICD)-10 codes for postoperative infections and inpatient rehabilitation care and used to calculate length of stay (LOS).

Results: Overall, 38.9% were sarcopenic; 16.7% had an infection and 9.0% had inpatient rehabilitation care. Length of stay was longer for sarcopenic patients overall (15.9 ± 14.2 days vs 12.3 ± 9.8 days, P=0.038) and especially in those ≥ 65 years (20.2 ± 16.9 days vs 13.1 ± 8.3 days, P=0.008). Infection risk was greater for sarcopenic patients overall (23.7% vs 12.5%; P=0.025), and especially those ≥ 65 years (29.6% vs 8.8%, P=0.005). Most (90%) inpatient rehabilitation care was in patients ≥ 65 years. Inpatient rehabilitation was more common in sarcopenic patients overall (14.3% vs 5.6%; P=0.024) and those ≥ 65 years (24.1% vs 10.7%, P=0.06). In a multivariate model in patients ≥ 65 years, sarcopenia was an independent predictor of both infection (odds ratio (OR) 4.6, (95% confidence interval (CI) 1.5, 13.9) P<0.01) and rehabilitation care (OR 3.1 (95% CI 1.04, 9.4) P<0.04).

Conclusion: Sarcopenia predicts postoperative infections, inpatient rehabilitation care and consequently a longer LOS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Canada / epidemiology
  • Colectomy / adverse effects*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / rehabilitation*
  • Colorectal Neoplasms / surgery*
  • Comorbidity
  • Female
  • Humans
  • Length of Stay / statistics & numerical data*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Odds Ratio
  • Patient Readmission
  • Postoperative Complications / etiology*
  • Postoperative Complications / rehabilitation
  • Predictive Value of Tests
  • Risk Factors
  • Sarcopenia / complications*
  • Sarcopenia / etiology
  • Sarcopenia / rehabilitation
  • Surgical Wound Infection / etiology*
  • Surgical Wound Infection / rehabilitation
  • Survival Analysis
  • Tomography, X-Ray Computed








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