Prevalence Of Sarcopenia And Its Effect On Postoperative Complications In Patients With Crohn's Disease Undergoing Intestinal Resection

Background & Aims: Sarcopenia has been considered to be a prognostic factor of outcomes for various diseases,but there are few reports on sarcopenia in patients with Crohn's disease(CD).We aimed to determine the prevalence of sarcopenia and assess the role of sarcopenia on postoperative outcomes after bowel resection in patients with CD at a tertiary referral center.Methods: In total,124 patients who underwent intestinal operations for CD from January 2013 to October 2019 were retrospectively evaluated.The L3 skeletal muscle mass index(SMI),which is the ratio of the cross-sectional area of skeletal muscles at the level of the third lumbar(L3)vertebra to the height squared,was used to identify sarcopenia.Demographic data,preoperative laboratory data,operative details and hospital outcomes were recorded.The impact of sarcopenia on postoperative complications was evaluated by using univariate and multivariate logistic regression analyses.Results: One hundred and twenty-four patients were enrolled.Thirty-four of them(27.4%)were diagnosed with sarcopenia,including 11 males and 23 females.Compared to patients without sarcopenia,sarcopenic patients had significantly lower BMI(P<0.001),lower preoperative serum albumin(P=0.006),pro-albumin(P=0.030)and hemoglobin levels(P<0.001),longer hospital stay(334.4±26.8 days vs 22.8 ±15.6days,P= 0.003)and more occurrences of complications(41.2% vs 23.3%,P= 0.049).In addition,the overall incidence of postoperative complications was 28.2%,among which infection(51.4%)and intestinal fistula(22.9%)were the most common.In multivariate analysis,Sarcopenia was identified as the independent risk factor for major postoperative complications(odds ratio = 3.974,95% CI =1.171-13.489,P =0.027).Conclusion: Sarcopenia is common in patients with CD requiring bowel resection,it significantly increases the risk of major postoperative complications.The assessment of sarcopenia can therefore be used to improve nutrition management and describe risks of postoperative complications clinically before surgery in patients with CD.