Impact of sarcopenic obesity on predicting the severity of acute pancreatitis

Chaigneau, Thomas; Morello, Rémy; Vannier, Elise; Musikas, M.; Piquet, Marie-Astrid; Dupont, B.

doi:10.1016/j.dld.2023.02.002

Digestive and Liver Disease

2023

DOI: 10.1016/j.dld.2023.02.002

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Impact of sarcopenic obesity on predicting the severity of acute pancreatitis

Thomas Chaigneau

Rémy Morello

Elise Vannier

et al.

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2024

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Cited by 2 publications

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Influence of sarcopenia as determined by bioelectrical impedance analysis in acute pancreatitis

Kilic,

Tahtaci,

Yagmur

et al. 2024

Medicine

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Sarcopenia can be defined as the loss of muscle mass and strength. It is a poor prognostic factor for many diseases. Our study aims to assess the prevalence of sarcopenia in patients with acute pancreatitis using bioelectrical impedance analysis (BIA) and hand dynamometry while also investigating its impact on acute pancreatitis. Sixty patients admitted with a diagnosis of acute pancreatitis were included in this prospective study. Following their admissions, prognostic markers were calculated, muscle strengths were measured using a hand dynamometer, and body compositions were determined using a BIA device. Accordingly, acute pancreatitis patients were divided into 2 groups: sarcopenic and nonsarcopenic. The demographic characteristics, anthropometric measurements, Ranson score, Glasgow-Imrie score, Balthazar score, APACHE-II score, disease severity according to the Atlanta classification, length of hospital stay, and laboratory findings of the 2 groups were compared. Sarcopenia was identified in 11 cases among those with acute pancreatitis included in the study. In the sarcopenic group, the mean age, Glasgow-Imrie score and number of cases with severe acute pancreatitis according to the Atlanta classification were significantly higher; body mass index, upper arm circumference, skeletal muscle mass index, and grip strength were significantly lower (P < .05). This study is the first to evaluate sarcopenia in acute pancreatitis cases using BIA and hand dynamometry. Sarcopenia may play a significant role in predicting the prognosis of acute pancreatitis.

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Influence of sarcopenia as determined by bioelectrical impedance analysis in acute pancreatitis

Kilic,

Tahtaci,

Yagmur

et al. 2024

Medicine

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Nutritional and Metabolic Status Control and Nutritional Support in Patients with Pancreatic Sepsis (Review)

Zhukov,

Gritsan,

Belyaev

et al. 2024

Obŝaâ reanimatologiâ

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Acute pancreatitis (AP) is associated with pancreonecrosis in 30% of patients, who may fall at 80% high risk of death when infected pancreatic necrosis progresses to sepsis. Given the catabolic nature of the disease and the signiﬁcant inﬂuence of nutritional status on its course and outcome, these patients require an adequate nutritional support (NS) based on an adequate assessment and control of nutritional and metabolic status.The aim of the study: to identify trends in developing new tools for assessment of nutritional and metabolic status, and provision of NS in patients with pancreatic sepsis (PS).Materials and methods. Keyword search in the PubMed, Scopus and E-library databases for the period from 2018 to 2023 yielded 95 publications, of which 16 meta-analyses and 6 systematic reviews met the requirements.Results. all existing to date scales for assessment of nutritional deﬁciency in patients with PS have low prognostic value. Of them, mNUTRIC scale seems to be the most appropriate assessment tool. Recommended by EPSEN guidelines tools to assess the risk of nutritional deﬁciency it is not suitable for ICU patients. Indirect calorimetry should be preferred vs routine calculation formulas in assessing patient’s energy needs in case of PS. It was also found that «standard» anthropometric values, such as BMI, are not always informative and prognostically signiﬁcant in patients with severe AP in the ICU. Analgesia, infusion therapy, as well as detection and correction of intraperitoneal hypertension are not only integral components of intensive care for PS but are indispensable for supplying adequate NS in PS patients. It was found that early enteral nutrition is the preferred method of NS, although questions concerning choice of tube insertion site, as well as all parameters of tube feeding remain unanswered. The optimal composition of enteral nutrition for patients with PS has not been established, which is indirectly conﬁrmed by the variety of enteral mixtures available on the market. The refeeding syndrome that occurs at initiation of NS was characterized as a life-threatening condition.Conclusion. NS, based on adequate assessment of disorders and control of the nutritional and metabolic status is an integral component of intensive care in PS patients. It can reduce the probability and number of potential complications, time of stay in the ICU, cost of treatment, and improve patient’s prognosis.

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Impact of sarcopenic obesity on predicting the severity of acute pancreatitis

Cited by 2 publications

References 27 publications

Influence of sarcopenia as determined by bioelectrical impedance analysis in acute pancreatitis

Influence of sarcopenia as determined by bioelectrical impedance analysis in acute pancreatitis

Nutritional and Metabolic Status Control and Nutritional Support in Patients with Pancreatic Sepsis (Review)

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