Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis

Background: Muscle mass and visceral fat may be assessed at the level of the third lumbar vertebra (L3) in computed tomography (CT). Both variables have been related with adverse surgical outcomes. Objective: The objective of the study was to study the association of skeletal muscle index (SMI) and...

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Main Authors:	Paulina Moctezuma-Velázquez, Omar Vergara-Fernández, Noel Salgado-Nesme, Jorge L. Aguilar-Frasco, Juan C. Sainz-Hernández, Carlos Moctezuma-Velázquez
Format:	article
Language:	EN
Published:	Permanyer 2021
Subjects:	Sarcopenia. Skeletal muscle. Visceral fat. Colorectal surgery. Internal medicine RC31-1245
Online Access:	https://doaj.org/article/eee6df062d7c44238a9ca2f3905fe55f
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spelling	oai:doaj.org-article:eee6df062d7c44238a9ca2f3905fe55f2021-11-09T14:24:38ZInfluence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis10.24875/RIC.210001080034-83762564-8896https://doaj.org/article/eee6df062d7c44238a9ca2f3905fe55f2021-01-01T00:00:00Zhttps://www.clinicalandtranslationalinvestigation.com/frame_esp.php?id=381https://doaj.org/toc/0034-8376https://doaj.org/toc/2564-8896Background: Muscle mass and visceral fat may be assessed at the level of the third lumbar vertebra (L3) in computed tomography (CT). Both variables have been related with adverse surgical outcomes. Objective: The objective of the study was to study the association of skeletal muscle index (SMI) and visceral fat area (VFA) with 30-day mortality in colorectal surgery. Methods: This is a retrospective cohort study conducted at a tertiary referral hospital in Mexico City. Patients who underwent colorectal surgery with primary anastomosis from January 2007 to December 2018 were included in the study. Their preoperative CT scans were analyzed with the NIH ImageJ software at the level of the third lumbar vertebra to determine their SMI (L3-SMI) and the VFA. Logistic regression analysis (adjusted by surgery anatomical location) was used to determine the association between these variables and surgical 30-day mortality. Results: A total of 548 patients were included; 30-day mortality was 4.18% (23 patients). On univariable analysis, L3-SMI, low SMI, anastomosis leak, pre-operative albumin, estimated blood loss, age, steroid use, Charlson comorbidity index score >2, and type of surgery were associated with 30-day mortality. On multivariable analysis, low SMI remained an independent risk factor with an odds ratio of 4.74, 95% confidence interval 1.22-18.36 (p = 0.02). Conclusion: Low SMI was found to be an independent risk factor for 30-day mortality in patients submitted to colorectal surgery with a primary anastomosis, whether for benign or malignant diagnosis. VFA was not associated with 30-day mortality Paulina Moctezuma-VelázquezOmar Vergara-FernándezNoel Salgado-NesmeJorge L. Aguilar-FrascoJuan C. Sainz-HernándezCarlos Moctezuma-VelázquezPermanyerarticleSarcopenia. Skeletal muscle. Visceral fat. Colorectal surgery.Internal medicineRC31-1245ENRevista de Investigación Clínica, Vol 73, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sarcopenia. Skeletal muscle. Visceral fat. Colorectal surgery. Internal medicine RC31-1245
spellingShingle	Sarcopenia. Skeletal muscle. Visceral fat. Colorectal surgery. Internal medicine RC31-1245 Paulina Moctezuma-Velázquez Omar Vergara-Fernández Noel Salgado-Nesme Jorge L. Aguilar-Frasco Juan C. Sainz-Hernández Carlos Moctezuma-Velázquez Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis
description	Background: Muscle mass and visceral fat may be assessed at the level of the third lumbar vertebra (L3) in computed tomography (CT). Both variables have been related with adverse surgical outcomes. Objective: The objective of the study was to study the association of skeletal muscle index (SMI) and visceral fat area (VFA) with 30-day mortality in colorectal surgery. Methods: This is a retrospective cohort study conducted at a tertiary referral hospital in Mexico City. Patients who underwent colorectal surgery with primary anastomosis from January 2007 to December 2018 were included in the study. Their preoperative CT scans were analyzed with the NIH ImageJ software at the level of the third lumbar vertebra to determine their SMI (L3-SMI) and the VFA. Logistic regression analysis (adjusted by surgery anatomical location) was used to determine the association between these variables and surgical 30-day mortality. Results: A total of 548 patients were included; 30-day mortality was 4.18% (23 patients). On univariable analysis, L3-SMI, low SMI, anastomosis leak, pre-operative albumin, estimated blood loss, age, steroid use, Charlson comorbidity index score >2, and type of surgery were associated with 30-day mortality. On multivariable analysis, low SMI remained an independent risk factor with an odds ratio of 4.74, 95% confidence interval 1.22-18.36 (p = 0.02). Conclusion: Low SMI was found to be an independent risk factor for 30-day mortality in patients submitted to colorectal surgery with a primary anastomosis, whether for benign or malignant diagnosis. VFA was not associated with 30-day mortality
format	article
author	Paulina Moctezuma-Velázquez Omar Vergara-Fernández Noel Salgado-Nesme Jorge L. Aguilar-Frasco Juan C. Sainz-Hernández Carlos Moctezuma-Velázquez
author_facet	Paulina Moctezuma-Velázquez Omar Vergara-Fernández Noel Salgado-Nesme Jorge L. Aguilar-Frasco Juan C. Sainz-Hernández Carlos Moctezuma-Velázquez
author_sort	Paulina Moctezuma-Velázquez
title	Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis
title_short	Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis
title_full	Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis
title_fullStr	Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis
title_full_unstemmed	Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis
title_sort	influence of muscle mass area and visceral obesity on 30-day mortality after colorectal surgery with primary anastomosis
publisher	Permanyer
publishDate	2021
url	https://doaj.org/article/eee6df062d7c44238a9ca2f3905fe55f
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Influence of Muscle Mass Area and Visceral Obesity on 30-day Mortality After Colorectal Surgery with Primary Anastomosis

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