Sarcopenia predicts poor outcomes in urgent exploratory laparotomy

Area of Science:

• Surgical outcomes research
• Geriatric surgery
• Abdominal surgery

Background:

• Emergent laparotomies carry significant risks of morbidity and mortality.
• Sarcopenia, reduced muscle mass, is increasingly recognized as a predictor of poor outcomes in elective surgery.
• Urgent surgical interventions may exacerbate the negative impact of sarcopenia.

Purpose of the Study:

• To investigate the association between sarcopenia and patient outcomes following urgent exploratory laparotomy.
• To identify sarcopenia as a potential predictor of morbidity and mortality in this patient population.

Main Methods:

• Retrospective review of 967 patients undergoing urgent laparotomy between 2010 and 2014 at a rural tertiary care facility.
• Abdomen/pelvis CT scans were utilized to assess sarcopenia, defined as the lowest quartile cross-sectional area of the psoas muscles.
• Primary outcomes included predictors of morbidity and mortality.

Main Results:

• Sarcopenic patients exhibited significantly higher mortality rates compared to non-sarcopenic patients.
• Sarcopenia was associated with increased complication rates, longer length of stay, and a greater likelihood of unplanned re-operation.
• Patients with increased abdominal wall fat demonstrated favorable outcomes regarding mortality, discharge destination, and complications.

Conclusions:

• Sarcopenia, readily measurable via CT scans, serves as an accessible and valuable predictor of outcomes in urgent laparotomies.
• The presence of sarcopenia in patients undergoing urgent laparotomy is linked to heightened morbidity, mortality, prolonged hospitalization, and adverse discharge destinations.