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Updated: Jan 14, 2026
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
A Simplified Method of Measuring Psoas Muscle Density to Predict Early Perioperative Outcomes: A Retrospective Cohort
Louis Scarrold1,2, Douglas Stupart1,3, Kevin Shaw1,4
1School of Medicine, Deakin University, Geelong, Victoria, Australia.
Background:
Sarcopenia describes a loss of muscle mass and function, which progresses with age. Sarcopenia predicts peri-operative morbidity and long-term survival. The most effective method to quantify sarcopenia is unclear, although measuring psoas muscle density (PMD) by circumscribing both psoas muscles and taking an average density appears promising. This research investigated whether the mean density of a representative ellipse from the psoas muscles (PMDe) provides a simpler approach to obtain the same prognostic information as PMD.
Methods:
This single-centre retrospective cohort study included 432 patients undergoing elective colorectal surgical resection at University Hospital Geelong (Victoria, Australia), 2007-2014. PMD and PMDe were measured from pre-operative CT scans. Pearson correlations investigated the relationship between PMD and PMDe. Logistic regression models described how these measures correlated with peri-operative morbidity. Kaplan-Meier curves described correlations with long-term survival.
Results:
PMDe correlated well with PMD (R2 = 0.818). Both PMDe and PMD correlated with major complications (OR = 0.962 (95% CI: 0.935-0.990) and OR = 0.963 (95% CI: 0.938-0.989), respectively) and peri-operative mortality (OR = 0.928 (95% CI: 0.873-0.988) and OR = 0.903 (95% CI: 0.847-0.962), respectively). Receiver Operating Curves (ROC) demonstrated PMDe (AUC = 0.770 (95% CI: 0.619-0.921)) was a slightly less sensitive marker of peri-operative mortality than PMD (AUC = 0.829 (95% CI: 0.731-0.928)). PMD correlated with long-term survival (p = 0.02); PMDe did not (p = 0.20).
Conclusion:
PMDe correlated closely with PMD and both were effective prognostic markers of perioperative outcomes in patients undergoing major elective colorectal surgery. Further studies of these measures as proxies for sarcopenia from other centres, and examining outcomes from a range of patient cohorts are warranted. These may inform shared decision making around the risks of major surgery.
