Relationship of the Psoas Muscle Index with the Other Nutritional Factors in Patients Who Underwent Emergency Operation with Colonic Perforation

Young Hun Kim, K. Lee, K. Kim
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Abstract

Purpose: This study examined the correlation between the preoperative nutritional index and Sarcopenia in emergency colonic perforation patients. Materials and Methods: Patients undergoing an emergency operation with colorectal perforation at Chosun University Hospital between January 2014 and December 2016 were included in the analysis, and the medical records were reviewed retrospectively. Sarcopenia was defined by the psoas muscle area measured by preoperative computed tomography (CT) cross sectional imaging at L3 vertebra. The clinical nutritional index of patients with PMI (psoas muscle index)-High group were compared with a PMI-Low group. Results: The median PMI of the males was 4.48 cm 2 /m 2 and the median of females was 3.33 cm 2 /m 2 (P=0.002) The PMI-High and PMI-Low groups were not correlated with age and gender (P=0.455 and P=0.806, respectively). The traditional indicators of the nutritional status, such as body mass index (BMI), albumin, and lymphocytes, were not associated with sarcopenia (P=0.094, P=0.676, and P=1.000, respectively). No significant difference was observed between the ASA classification and sarcopenia (P=0.145). Conclusion: Sarcopenia using PMI was not associated with previous nutritional indices in patients undergoing emergency surgery due to colonic perforation. In the future, large-scale studies will need to identify its role as a prognostic factor. (Surg Metab Nutr 2018;9:36-40)
急诊结肠穿孔手术患者腰肌指数与其他营养因子的关系
目的:探讨急诊结肠穿孔患者术前营养指数与骨骼肌减少的相关性。材料与方法:选取2014年1月至2016年12月在朝鲜大学医院急诊手术的结直肠穿孔患者,对其病历进行回顾性分析。骨骼肌减少症是通过术前计算机断层扫描(CT)在L3椎体测量腰肌面积来定义的。比较PMI-高组与PMI-低组患者的临床营养指数。结果:男性PMI中位数为4.48 cm 2 / m2,女性PMI中位数为3.33 cm 2 / m2 (P=0.002), PMI-高、低组与年龄、性别无关(P=0.455、P=0.806)。体重指数(BMI)、白蛋白、淋巴细胞等传统营养状况指标与肌肉减少症无相关性(P=0.094、P=0.676、P=1.000)。ASA分级与肌少症无显著性差异(P=0.145)。结论:采用PMI检测的结肠穿孔急诊手术患者肌肉减少症与既往营养指标无相关性。在未来,大规模的研究将需要确定其作为预后因素的作用。(中华外科杂志2018;9:36-40)
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