Sarcopenia in emergency abdominal surgery

Dirks, Rebecca; Edwards, Brandy L.; Tong, Elizabeth; Schaheen, Basil; Turrentine, Florence E.; Shada, Amber L.; Smith, Philip W.

doi:10.1016/j.jss.2016.08.015

Cited by 57 publications

(55 citation statements)

References 21 publications

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“…Although baseline sarcopenia and frailty have been increasingly implicated in adverse EGS outcomes, these results are derived from small single‐center cohorts. Furthermore, although reported prevalence of frailty varies based on setting and measurement tool, a review of 21 studies examining frailty among community‐dwelling older adults found an average prevalence of frailty of 11% .…”

Section: Discussionmentioning

confidence: 99%

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Loss of Community‐Dwelling Status Among Survivors of High‐Acuity Emergency General Surgery Disease

Smith

Davis

Quatman‐Yates

et al. 2019

J American Geriatrics Society

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OBJECTIVES To examine loss of community‐dwelling status 9 months after hospitalization for high‐acuity emergency general surgery (HA‐EGS) disease among older Americans. DESIGN Retrospective analysis of claims data. SETTING US communities with Medicare beneficiaries. PARTICIPANTS Medicare beneficiaries age 65 years or older hospitalized urgently/emergently between January 1, 2015, and March 31, 2015, with a principal diagnosis representing potential life or organ threat (necrotizing soft tissue infections, hernias with gangrene, ischemic enteritis, perforated viscus, toxic colitis or gastroenteritis, peritonitis, intra‐abdominal hemorrhage) and an operation of interest on hospital days 1 or 2 (N = 3319). MEASUREMENTS Demographic characteristics (age, race, and sex), comorbidities, principal diagnosis, complications, and index hospitalization disposition (died; discharged to skilled nursing facility [SNF], long‐term acute care [LTAC], rehabilitation, hospice, home (with or without services), or acute care hospital; other) were measured. Survivors of index hospitalization were followed until December 31, 2015, on mortality and community‐dwelling status (SNF/LTAC vs not). Descriptive statistics, Kaplan‐Meier plots, and χ2 tests were used to describe and compare the cohort based on disposition. A multivariable logistic regression model, adjusted for age, sex, comorbidities, complications, and discharge disposition, determined independent predictors of loss of community‐dwelling status at 9 months. RESULTS A total of 2922 (88%) survived index hospitalization. Likelihood of discharge to home decreased with increasing age, baseline comorbidities, and in‐hospital complications. Overall, 418 (14.3%) HA‐EGS survivors died during the follow‐up period. Among those alive at 9 months, 10.3% were no longer community dwelling. Initial discharge disposition to any location other than home and three or more surgical complications during index hospitalization were independent predictors of residing in a SNF/LTAC 9 months after surviving HA‐EGS. CONCLUSION Older Americans, known to prioritize living in the community, will experience substantial loss of independence due to HA‐EGS. Long‐term expectations after surviving HA‐EGS must be framed from the perspective of the outcomes that older patients value the most. Further research is needed to examine the quality‐of‐life burden of EGS survivorship prospectively. J Am Geriatr Soc 67:2289–2297, 2019

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Section: Discussionmentioning

confidence: 99%

“…Most studies focusing on older individuals with EGS disease focused on intra‐abdominal pathologies . Similarly, most of our older cohort underwent urgent or emergent abdominal surgery for a variety of serious conditions.…”

Section: Discussionmentioning

confidence: 99%

Loss of Community‐Dwelling Status Among Survivors of High‐Acuity Emergency General Surgery Disease

Smith

Davis

Quatman‐Yates

et al. 2019

J American Geriatrics Society

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“…The total psoas area was measured by determining the total cross-sectional area of the right and left psoas muscles. The level of the fourth lumbar vertebra was chosen based on the literature on sarcopenia (3,12,14). The level of the L4 vertebra was identified, and the total psoas area was measured at the superior margin of the L4 vertebra by manually tracing the outline of the muscle.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, with the increasing aging population, the number of elderly patients undergoing emergency surgery is increasing. The loss of muscle mass and function with aging is a practical measure of frailty and has been identified as a predictor of outcomes in elderly patients (13,14).…”

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confidence: 99%

The Impact of Low Muscle Mass in Patients Undergoing Emergency Surgery for Colonic Perforation – A Single-center Experience

Imamura

Haraguchi

Minami

et al. 2019

In Vivo

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Aim: The aim was to analyze the correlation between psoas muscle mass and mortality, as well as postoperative complications in patients treated for colonic perforation. Patients and Methods: A total of 46 patients met the study criteria. Patients were classified into an elderly (age, ≥75 years, n=24) and a younger group (age, <75 years, n=22). Background factors, postoperative data (including duration of hospital stay and discharge) were collected. The cross-sectional area of the psoas muscle area (PMA) was measured on the same day of operation. Results: The age/length of stay and PMA were significantly correlated in the younger group (p=0.0015, 0.023, respectively). Fifteen and six patients were discharged to return home, and 8 and 16 patients were transferred to another hospital, in the younger and elderly groups, respectively (p=0.02). Discharge was not correlated with the PMA in either group. Conclusion: The total psoas muscle mass would be useful as a quick and convenient measure of sarcopenia in younger patients, but not elderly patients.Sarcopenia is a syndrome characterized by a progressive and generalized loss of skeletal muscle mass and strength and is associated with an increased risk of adverse outcomes, such as physical disability, a poor quality of life, 523 This article is freely accessible online.

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“…7 In noncancer patients, CT-measured sarcopenia was associated with increased mortality in patients with chronic liver disease, chronic renal disease, pneumonia, and sepsis as well as in intensive care unit (ICU), trauma, vascular surgery, general surgery, orthopaedic surgery, and transplant patients. [44][45][46][47][48][49][50][51][52][53][54][55][56] In a cohort of 450 trauma patients age ! 65 years admitted to the ICU, CT-measured sarcopenia was associated with 1-year mortality.…”

Section: Consequences Of Sarcopeniamentioning

confidence: 99%

Sarcopenia: Beyond Muscle Atrophy and into the New Frontiers of Opportunistic Imaging, Precision Medicine, and Machine Learning

Lenchik

Boutin

2018

Semin Musculoskelet Radiol

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As populations continue to age worldwide, the impact of sarcopenia on public health will continue to grow. The clinically relevant and increasingly common diagnosis of sarcopenia is at the confluence of three tectonic shifts in medicine: opportunistic imaging, precision medicine, and machine learning. This review focuses on the state-of-the-art imaging of sarcopenia and provides context for such imaging by discussing the epidemiology, pathophysiology, consequences, and future directions in the field of sarcopenia.

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Sarcopenia in emergency abdominal surgery

Cited by 57 publications

References 21 publications

Loss of Community‐Dwelling Status Among Survivors of High‐Acuity Emergency General Surgery Disease

Loss of Community‐Dwelling Status Among Survivors of High‐Acuity Emergency General Surgery Disease

The Impact of Low Muscle Mass in Patients Undergoing Emergency Surgery for Colonic Perforation – A Single-center Experience

Sarcopenia: Beyond Muscle Atrophy and into the New Frontiers of Opportunistic Imaging, Precision Medicine, and Machine Learning

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