Implications of sarcopenia in major surgery

Area of Science:

• Gerontology and clinical medicine.
• Radiology and medical imaging analysis.

Background:

• Sarcopenia, characterized by decreased muscle mass and strength, is a significant risk factor for frailty, mortality, and adverse surgical outcomes.
• Current methods for sarcopenia assessment are subjective and lack precision.
• Computed tomography (CT) imaging offers objective quantification of sarcopenia for risk stratification.

Purpose of the Study:

• To objectively measure sarcopenia using analytic morphomics.
• To stratify surgical risk and identify patients for a remediation program.
• To evaluate the effectiveness of a perioperative optimization program for sarcopenia.

Main Methods:

• Analytic morphomics, a semiautomated CT scan analysis using MATLAB, was employed.
• The study included general, vascular, and liver transplant surgery patient populations.
• A perioperative optimization program focused on improving patients' mental and physical status was implemented.

Main Results:

• Sarcopenic patients exhibited significantly higher costs, mortality rates, and surgical complications.
• The perioperative training program demonstrated initial success in mitigating these risks.
• Participating patients showed reduced hospital and payer costs and shorter hospital stays.

Conclusions:

• Analytic morphomics accurately quantifies sarcopenia markers and identifies at-risk individuals.
• Early identification enables sarcopenia remediation via perioperative training and support.
• This approach improves patient outcomes, reduces healthcare expenses, and enhances the perioperative experience.