Potential Associations Between CT-Derived Muscle Indices and Clinical Outcomes in Acute Pancreatitis

Area of Science:

• Radiology
• Gastroenterology
• Critical Care Medicine

Background:

• Acute pancreatitis (AP) is a common gastrointestinal emergency requiring early risk stratification.
• CT-derived muscle mass indices (psoas muscle index [PMI] and paravertebral muscle index [PvMI]) reflect nutritional and inflammatory status.
• Identifying high-risk AP patients early is crucial for improving outcomes.

Purpose of the Study:

• To investigate the association between CT-derived PMI and PvMI and AP severity, complications, and ICU admission.
• To evaluate the prognostic value of PMI and PvMI in age- and sex-specific subgroups.

Main Methods:

• Retrospective study of 179 AP patients.
• Measurement of psoas muscle area (PMA) and paravertebral muscle area (PvMA) at L3 on CT scans.
• Calculation of PMI and PvMI, with subgroup analyses by sex and age (≥65 years).

Main Results:

• PMI correlated with albumin, hemoglobin, and inflammatory markers.
• In women, PMI was independently associated with complicated AP (aOR=0.655).
• In patients ≥65 years, PvMI was independently associated with ICU requirement (aOR=0.780).
• Optimal cutoffs: PMI ≤ 4.04 cm²/m² for complicated AP (AUC=0.641), PvMI ≤ 18.88 cm²/m² for ICU need (AUC=0.684).

Conclusions:

• CT-derived muscle indices (PMI, PvMI) show potential as prognostic markers in AP.
• These indices may help identify high-risk patients, particularly older and female individuals.
• Further validation in larger prospective cohorts is recommended for timely interventions.