Background

Inflammatory bowel disease (IBD) is a relatively common disorder with significant associated morbidity. Sarcopenia and myosteatosis are associated with adverse postoperative outcomes. This study investigated outcomes in IBD patients undergoing surgical resection relative to the presence of sarcopenia and myosteatosis.

Methods

A retrospective analysis of a prospectively maintained surgical database was conducted. All patients undergoing elective or emergency resection for IBD between 2011 and 2016, with a contemporaneous perioperative computed tomography (CT) scan, were included. Patient demographics, clinical and biochemical measurements were collected. Skeletal muscle index and attenuation were measured on perioperative CT scans using Osirix version 5.6.1. Univariate and multivariate regression analysis was used to identify risk factors for adverse postoperative outcomes.

Results

Seventy-seven patients (46 male, 31 female; mean age 42 years, range 20–80 years) were included. Thirty patients (30%) had sarcopenia and 26 (34%) had myosteatosis. Myosteatosis was significantly associated with increased hospital stay postoperatively (9 versus 13 days). Sarcopenia and myosteatosis were associated with hospital readmission within 30 days on univariate analysis. Multivariate regression analysis demonstrated an independent association between myosteatosis and hospital readmission. Sixteen patients (21%) had a clinically relevant postoperative complication, but an association with sarcopenia and myosteatosis was not observed. A neutrophil-lymphocyte ratio greater than 5 was predictive of clinically relevant postoperative complications on multivariate regression analysis.

Conclusions

Myosteatosis was associated with increased hospital stay and increased 30-day hospital readmission rates on multivariate regression analysis. Sarcopenia and myosteatosis in IBD were not associated with clinically relevant postoperative complications.

中文翻译：

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肌肉减少症和肌脂溢性病对炎症性肠病患者术后结局的影响。

背景

炎性肠病（IBD）是一种相对常见的疾病，伴有明显的发病率。肌肉减少症和肌脂肪变性与术后不良后果相关。这项研究调查了相对于肌肉减少症和肌脂变性的存在，接受外科手术切除的IBD患者的结局。

方法

回顾性分析前瞻性维护的手术数据库。纳入所有在2011年至2016年间接受IBD择期或急诊切除术并同时进行围手术期计算机断层扫描（CT）扫描的患者。收集患者的人口统计资料，临床和生化指标。使用Osirix版本5.6.1在围手术期CT扫描中测量骨骼肌指数和衰减。单因素和多因素回归分析被用来确定术后不良结局的危险因素。

结果

纳入了77例患者（男46例，女31例；平均年龄42岁，范围20-80岁）。30例（30％）患有肌肉减少症，26例（34％）患有肌脂变性。肌脂肪变性与术后住院时间增加显着相关（9天比13天）。单因素分析显示，少肌症和肌脂肪变性与住院30天内再入院有关。多元回归分析表明，肌成肌病和住院再入院之间存在独立的联系。16例患者（21％）具有临床相关的术后并发症，但未观察到与肌肉减少症和肌脂变性相关。在多元回归分析中，中性粒细胞-淋巴细胞比率大于5可以预示临床相关的术后并发症。

结论

多元代谢回归分析显示，肌脂肪变性与住院时间增加和30天住院率增加有关。IBD的肌肉减少症和肌脂代谢与临床相关的术后并发症无关。