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Published on: February 14, 2025
Psoas Muscle Volume as a Predictor of Postoperative Complications in Patients Undergoing Emergency Surgery for
Takuya Shiraishi1, Chika Katayama1, Yuta Shibasaki1
1Department of General Surgical Science Gunma University Graduate School of Medicine Maebashi Gunma Japan.
Aim:
This study evaluated preoperative psoas muscle volume, measured by plain computed tomography, as an independent predictor of short-term postoperative outcomes in patients undergoing surgery for strangulated small bowel obstruction, and examined the impact of postoperative complications.
Methods:
This retrospective, single-center study included 107 patients who underwent emergency strangulated small bowel obstruction surgery between January 2013 and December 2024. Demographics, clinical and surgical variables, laboratory values, and outcomes were reviewed. Psoas muscle volume, subcutaneous fat area, visceral fat area, and psoas muscle index were measured on preoperative computed tomography.
Results:
Receiver operating characteristic analysis identified 45.4 as the optimal psoas muscle volume cutoff, dividing patients into high (≥ 45.4) and low (< 45.4) groups. The low psoas muscle volume group was older, with lower BMI, nutritional indices, and serum albumin. Complications occurred more frequently in the low psoas muscle volume group, most commonly pneumonia. Severe complications (Clavien-Dindo ≥ III) were confined to patients aged ≥ 75 years, predominantly with low psoas muscle volume. Multivariate analysis identified advanced age and low psoas muscle volume as independent risk factors. Complications were associated with delayed bowel recovery, longer hospitalization, and reduced home-discharge rates. Low psoas muscle volume independently predicted cardiopulmonary and systemic complications but not infectious or gastrointestinal complications.
Conclusion:
Advanced age and low psoas muscle volume independently predicted postoperative complications. Low psoas muscle volume was particularly linked to cardiopulmonary and systemic events, highlighting the need for preoperative risk stratification and early multidisciplinary management in older adults having strangulated small bowel obstruction with reduced muscle mass.
Trial Registration:
Not applicable.
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