The Impact of Sarcopenia on Early Postoperative Complications in Patients Undergoing Decortication due to Empyema: A Retrospective Study in Turkey.

Abstract

Background: Sarcopenia is a progressive skeletal muscle disorder characterized by the loss of muscle mass and function. Computed tomography (CT) scans are a reliable method for diagnosing sarcopenia, as they allow for the measurement of muscle density using Hounsfield units (HU). In this study, we conducted a retrospective investigation into the prevalence of sarcopenia and its impact on postoperative complications in patients who underwent decortication for empyema.

Methods: Between September 2020 and August 2023, we measured the average HU values of the bilateral paravertebral muscles at the T12 thoracic vertebra level using CT. This study included 145 patients who underwent thoracotomy and decortication for empyema at the Thoracic Surgery Clinic of Konya City Hospital. Based on their HU values, patients were categorized into 2 groups: the sarcopenia group (group S) and the control group (group C). Our objectives were to determine the prevalence of sarcopenia in these patients, evaluate its influence on early postoperative complications, and explore its potential role as a risk factor for postoperative complications.

Results: Sarcopenia was identified in 49 (33.7%) of the patients who underwent thoracotomy and decortication for empyema. In group S, the rates of postoperative surgical site infection and pneumonia were significantly higher. Regression analysis revealed that sarcopenia was an independent risk factor for both postoperative pneumonia and surgical site infection. Additionally, the length of stay in the intensive care unit and the hospital was significantly longer in group S than in group C.

Conclusion: In patients who underwent thoracotomy for empyema, sarcopenia independently increases the risk of postoperative pneumonia and surgical site infections.