Sarcopenia and adverse surgical outcomes following cholecystectomy

Postoperative complications and mortality following cholecystectomy persist despite the procedural simplicity. We utilized a nationwide administrative database from Taiwan and conducted propensity score matching (PSM) to investigate the association between sarcopenia and major postoperative complications.

This retrospective cohort study analyzed data from the Taiwan National Health Insurance Research Database from 2016 to 2020. Patients who underwent elective cholecystectomy under general anesthesia for gallstone disease were included. They were categorized into two groups: those with sarcopenia and those without. The cohorts were matched at a 1:4 ratio using PSM.

PSM yielded a final cohort of 13,330 surgical patients (10,664 without sarcopenia and 2666 with sarcopenia). Multivariate logistic regression demonstrated that sarcopenia was significantly associated with higher 30 day mortality (adjusted odds ratio [aOR] = 2.26, 95% confidence interval [CI] 1.61-3.18) and major complications, including acute renal failure (aOR = 1.71, 95% CI 1.02-2.84), pneumonia (aOR = 1.68, 95% CI 1.22-2.31), stroke (aOR = 1.13, 95% CI 1.06-1.57), and overall complications (aOR = 1.23, 95% CI 1.07-1.41). Sarcopenia also increased the risk of 90-day mortality (aOR = 2.09, 95% CI 1.58-2.76) and 90-day major complications, including acute renal failure (aOR = 1.61, 95% CI 1.01-2.56), pneumonia (aOR = 1.70, 95% CI 1.30-2.21), stroke (aOR = 1.28, 95% CI 1.04-1.58), and overall complications (aOR = 1.24, 95% CI 1.09-1.41).

We found that sarcopenia is an independent risk factor for increased postoperative complications and mortality following cholecystectomy. These findings highlight the importance of preoperative sarcopenia assessment to improve surgical outcomes.