Impact of sarcopenia on surgical site infection after restorative proctocolectomy for ulcerative colitis

Purpose The coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association between sarcopenia and surgical site infection (SSI) after surgery for ulcerative colitis. Methods The subjects of this retrospective study...

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Published in	Surgery today (Tokyo, Japan) Vol. 47; no. 1; pp. 92 - 98
Main Authors	Fujikawa, Hiroyuki, Araki, Toshimitsu, Okita, Yoshiki, Kondo, Satoru, Kawamura, Mikio, Hiro, Junichiro, Toiyama, Yuji, Kobayashi, Minako, Tanaka, Koji, Inoue, Yasuhiro, Mohri, Yasuhiko, Uchida, Keiichi, Kusunoki, Masato
Format	Journal Article
Language	English
Published	Tokyo Springer Japan 01.01.2017
Subjects	Adult Colitis, Ulcerative - complications Colitis, Ulcerative - diagnostic imaging Colitis, Ulcerative - surgery Enteral Nutrition Female Humans Male Medicine Medicine & Public Health Middle Aged Original Article Proctocolectomy, Restorative Retrospective Studies Sarcopenia - complications Sarcopenia - diagnostic imaging Surgery Surgical Oncology Surgical Wound Infection - etiology Tomography, X-Ray Computed Surgical site infection Sarcopenia Proctocolectomy Ulcerative colitis
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ISSN	0941-1291 1436-2813 1436-2813
DOI	10.1007/s00595-016-1357-x

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Abstract	Purpose The coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association between sarcopenia and surgical site infection (SSI) after surgery for ulcerative colitis. Methods The subjects of this retrospective study were 69 patients who underwent restorative proctocolectomy with perioperative abdominal computed tomography (CT). Sarcopenia was diagnosed by measuring the cross-sectional area of the right and left psoas muscles as the total psoas muscle area on CT images. We assessed whether sarcopenia was associated with SSI and clinical factors, including nutritional and inflammatory markers. Results The lowest quartiles defined as sarcopenia in men and women were 567.4 and 355.8 mm 2 /m 2 , respectively. According to this classification, 12 men and 6 women had sarcopenia. Patients with sarcopenia had a lower body mass index ( p = 0.0004) and a higher C-reactive protein concentration ( p = 0.05) than those without sarcopenia. SSIs were identified in 12 patients (17.3 %) and included six pelvic abscesses and seven wound infections. According to multivariate analysis, sarcopenia was an independent risk factor for SSI (odds ratio = 4.91, 95 % confidence interval 1.09–23.5, p = 0.03). Conclusion Sarcopenia is predictive of SSI after pouch surgery for ulcerative colitis.
AbstractList	The coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association between sarcopenia and surgical site infection (SSI) after surgery for ulcerative colitis.PURPOSEThe coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association between sarcopenia and surgical site infection (SSI) after surgery for ulcerative colitis.The subjects of this retrospective study were 69 patients who underwent restorative proctocolectomy with perioperative abdominal computed tomography (CT). Sarcopenia was diagnosed by measuring the cross-sectional area of the right and left psoas muscles as the total psoas muscle area on CT images. We assessed whether sarcopenia was associated with SSI and clinical factors, including nutritional and inflammatory markers.METHODSThe subjects of this retrospective study were 69 patients who underwent restorative proctocolectomy with perioperative abdominal computed tomography (CT). Sarcopenia was diagnosed by measuring the cross-sectional area of the right and left psoas muscles as the total psoas muscle area on CT images. We assessed whether sarcopenia was associated with SSI and clinical factors, including nutritional and inflammatory markers.The lowest quartiles defined as sarcopenia in men and women were 567.4 and 355.8 mm2/m2, respectively. According to this classification, 12 men and 6 women had sarcopenia. Patients with sarcopenia had a lower body mass index (p = 0.0004) and a higher C-reactive protein concentration (p = 0.05) than those without sarcopenia. SSIs were identified in 12 patients (17.3 %) and included six pelvic abscesses and seven wound infections. According to multivariate analysis, sarcopenia was an independent risk factor for SSI (odds ratio = 4.91, 95 % confidence interval 1.09-23.5, p = 0.03).RESULTSThe lowest quartiles defined as sarcopenia in men and women were 567.4 and 355.8 mm2/m2, respectively. According to this classification, 12 men and 6 women had sarcopenia. Patients with sarcopenia had a lower body mass index (p = 0.0004) and a higher C-reactive protein concentration (p = 0.05) than those without sarcopenia. SSIs were identified in 12 patients (17.3 %) and included six pelvic abscesses and seven wound infections. According to multivariate analysis, sarcopenia was an independent risk factor for SSI (odds ratio = 4.91, 95 % confidence interval 1.09-23.5, p = 0.03).Sarcopenia is predictive of SSI after pouch surgery for ulcerative colitis.CONCLUSIONSarcopenia is predictive of SSI after pouch surgery for ulcerative colitis. The coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association between sarcopenia and surgical site infection (SSI) after surgery for ulcerative colitis. The subjects of this retrospective study were 69 patients who underwent restorative proctocolectomy with perioperative abdominal computed tomography (CT). Sarcopenia was diagnosed by measuring the cross-sectional area of the right and left psoas muscles as the total psoas muscle area on CT images. We assessed whether sarcopenia was associated with SSI and clinical factors, including nutritional and inflammatory markers. The lowest quartiles defined as sarcopenia in men and women were 567.4 and 355.8 mm /m , respectively. According to this classification, 12 men and 6 women had sarcopenia. Patients with sarcopenia had a lower body mass index (p = 0.0004) and a higher C-reactive protein concentration (p = 0.05) than those without sarcopenia. SSIs were identified in 12 patients (17.3 %) and included six pelvic abscesses and seven wound infections. According to multivariate analysis, sarcopenia was an independent risk factor for SSI (odds ratio = 4.91, 95 % confidence interval 1.09-23.5, p = 0.03). Sarcopenia is predictive of SSI after pouch surgery for ulcerative colitis. Purpose The coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association between sarcopenia and surgical site infection (SSI) after surgery for ulcerative colitis. Methods The subjects of this retrospective study were 69 patients who underwent restorative proctocolectomy with perioperative abdominal computed tomography (CT). Sarcopenia was diagnosed by measuring the cross-sectional area of the right and left psoas muscles as the total psoas muscle area on CT images. We assessed whether sarcopenia was associated with SSI and clinical factors, including nutritional and inflammatory markers. Results The lowest quartiles defined as sarcopenia in men and women were 567.4 and 355.8 mm 2 /m 2 , respectively. According to this classification, 12 men and 6 women had sarcopenia. Patients with sarcopenia had a lower body mass index ( p = 0.0004) and a higher C-reactive protein concentration ( p = 0.05) than those without sarcopenia. SSIs were identified in 12 patients (17.3 %) and included six pelvic abscesses and seven wound infections. According to multivariate analysis, sarcopenia was an independent risk factor for SSI (odds ratio = 4.91, 95 % confidence interval 1.09–23.5, p = 0.03). Conclusion Sarcopenia is predictive of SSI after pouch surgery for ulcerative colitis.
Author	Kondo, Satoru Uchida, Keiichi Okita, Yoshiki Tanaka, Koji Kusunoki, Masato Kawamura, Mikio Toiyama, Yuji Hiro, Junichiro Fujikawa, Hiroyuki Araki, Toshimitsu Kobayashi, Minako Inoue, Yasuhiro Mohri, Yasuhiko
Author_xml	– sequence: 1 givenname: Hiroyuki surname: Fujikawa fullname: Fujikawa, Hiroyuki email: f0609@clin.medic.mie-u.ac.jp organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 2 givenname: Toshimitsu surname: Araki fullname: Araki, Toshimitsu organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 3 givenname: Yoshiki surname: Okita fullname: Okita, Yoshiki organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 4 givenname: Satoru surname: Kondo fullname: Kondo, Satoru organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 5 givenname: Mikio surname: Kawamura fullname: Kawamura, Mikio organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 6 givenname: Junichiro surname: Hiro fullname: Hiro, Junichiro organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 7 givenname: Yuji surname: Toiyama fullname: Toiyama, Yuji organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 8 givenname: Minako surname: Kobayashi fullname: Kobayashi, Minako organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 9 givenname: Koji surname: Tanaka fullname: Tanaka, Koji organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 10 givenname: Yasuhiro surname: Inoue fullname: Inoue, Yasuhiro organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 11 givenname: Yasuhiko surname: Mohri fullname: Mohri, Yasuhiko organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 12 givenname: Keiichi surname: Uchida fullname: Uchida, Keiichi organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine – sequence: 13 givenname: Masato surname: Kusunoki fullname: Kusunoki, Masato organization: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine
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Keywords	Surgical site infection Sarcopenia Proctocolectomy Ulcerative colitis
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Snippet	Purpose The coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association... The coexistence of sarcopenia is associated with postoperative complications, including infection after abdominal surgery. We evaluated the association between...
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SubjectTerms	Adult Colitis, Ulcerative - complications Colitis, Ulcerative - diagnostic imaging Colitis, Ulcerative - surgery Enteral Nutrition Female Humans Male Medicine Medicine & Public Health Middle Aged Original Article Proctocolectomy, Restorative Retrospective Studies Sarcopenia - complications Sarcopenia - diagnostic imaging Surgery Surgical Oncology Surgical Wound Infection - etiology Tomography, X-Ray Computed
Title	Impact of sarcopenia on surgical site infection after restorative proctocolectomy for ulcerative colitis
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