The cost of major surgery in the sarcopenic patient

Sheetz, Kyle H.; Waits, Seth A.; Terjimanian, Michael N.; Sullivan, J. A.; Campbell, Darrell A.; Wang, Stewart C.; Englesbe, Michael J.

doi:10.1016/j.jamcollsurg.2013.07.242

Cited by 13 publications

(21 citation statements)

References 17 publications

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“…Low muscle mass was associated with adverse LTx outcomes in six of the eleven studies. This is consistent with other major surgical procedures and transplant populations, including liver and renal transplant, that have highlighted adverse postoperative outcomes with low muscle mass [34–37]. This can be partly explained by the fact that low muscle mass represents a state of catabolism with diminished physiological reserve, which is important in order to combat critical illness and infection [38,39].…”

Section: Discussionsupporting

confidence: 82%

Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

et al. 2020

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Summary Computed tomography (CT) is gaining increased recognition in the assessment of body composition in lung transplant (LTx) candidates as a prognostic marker of post‐transplant outcomes. This systematic review was conducted to describe the methodology of CT measures of body composition used in LTx patients and its association with post‐transplant outcomes. Six databases were searched (inception‐April 2020) for studies of adult LTx patients with thoracic or abdominal CT measures [muscle cross‐sectional area (CSA) and/or adiposity]. Thirteen articles were included with 1911 LTx candidates, 58% males, mean age range (48–61 years) and body mass index of 21.0–26.1 kg/m2. Several methods were utilized using thoracic or abdominal CT scans to assess skeletal muscle (n = 11) and adiposity (n = 4) at various anatomic locations (carina, thoracic, and lumbar vertebrae), differing muscle groups, and adipose tissue compartments. Low muscle mass was associated with adverse outcomes in 6/11 studies, including longer mechanical ventilation days (n = 2), intensive care (n = 2) and hospital stay (n = 2), and mortality (n = 4). Greater subcutaneous and mediastinal fat were associated with increased risk of primary graft dysfunction (n = 2), but implications of adiposity on survival were variable across four studies. Further standardization of CT body composition assessments is needed to assess the prognostic utility of these measures on LTx outcomes.

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Section: Discussionsupporting

confidence: 82%

Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

et al. 2020

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“…It has been suggested that regular exercise prevents frailty and improves skeletal muscle mass and physical function in older patients, but further studies are needed to assess the effects of preoperative training on muscle mass and survival. In general, modulating skeletal muscle mass seems possible and may therefore represent a promising strategy towards improving postoperative outcomes and even lowering health care costs …”

Section: Discussionmentioning

confidence: 99%

Preoperative computed tomography assessment of skeletal muscle mass is valuable in predicting outcomes following hepatectomy for perihilar cholangiocarcinoma

Coelen

Wiggers

Nio

et al. 2015

HPB

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“…In patients with cirrhosis, low skeletal muscle mass is associated with increased mortality on the liver transplantation waiting list and post‐transplant morbidity and mortality, independently of well‐established predictors such as the MELD score . Sarcopenia has also been associated with higher healthcare costs in abdominal cancer patients undergoing surgery . To date, only one study from the United States described the association between gait speed, as a measure of frailty, and increased hospital costs in patients with cirrhosis .…”

Section: Introductionmentioning

confidence: 99%

Low skeletal muscle mass is associated with increased hospital costs in patients with cirrhosis listed for liver transplantation-a retrospective study

et al. 2017

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Low skeletal muscle mass (sarcopenia) is associated with increased morbidity and mortality in liver transplant candidates. We investigated the association between sarcopenia and hospital costs in patients listed for liver transplantation. Consecutive patients with cirrhosis listed for liver transplantation between 2007 and 2014 in a Eurotransplant centre were identified. The skeletal muscle index (SMI, cm /m ) was measured on CT performed within 90 days from waiting list placement. The lowest sex-spe cific quartile represented patients with sarcopenia. In total, 224 patients were included. Median time on the waiting list was 170 (IQR 47-306) days, and median MELD score was 16 (IQR 11-20). The median total hospital costs in patients with sarcopenia were €11 294 (IQR 3570-46 469) compared with €6878 (IQR 1305-20 683) in patients without sarcopenia (P = 0.008). In multivariable regression analysis, an incremental increase in SMI was significantly associated with a decrease in total costs (€455 per incremental SMI, 95% CI 11-900, P = 0.045), independent of the total time on the waiting list. In conclusion, sarcopenia is independently associated with increased health-related costs for patients on the waiting list for liver transplantation. Optimizing skeletal muscle mass may therefore lead to a decrease in hospital expenditure, in addition to greater health benefit for the transplant candidate.

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The cost of major surgery in the sarcopenic patient

Abstract: Background-Sarcopenia is associated with poor outcomes after major surgery. There are currently no data regarding the financial implications of providing care for these high-risk patients.

Cited by 13 publications

References 17 publications

Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

Preoperative computed tomography assessment of skeletal muscle mass is valuable in predicting outcomes following hepatectomy for perihilar cholangiocarcinoma

Low skeletal muscle mass is associated with increased hospital costs in patients with cirrhosis listed for liver transplantation-a retrospective study

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