title: Simple psoas cross-sectional area measurement is a quick and easy method to assess sarcopenia and predicts major surgical complications.
abstract: OBJECTIVE
  Radiologically assessed muscle mass has been suggested as a surrogate marker of functional status and frailty and may predict patients at risk of postoperative complications. We hypothesize that sarcopenia negatively impacts on postoperative recovery and is predictive of complications.
  
  
  METHODS
  One hundred patients undergoing elective resection for colorectal carcinoma were included in this study. Lean muscle mass was estimated by measuring the cross-sectional area of the psoas muscle at the level of the third lumbar vertebra identified on a preoperative CT scan, normalizing for patient height. Perioperative morbidity was scored according to the Clavien-Dindo classification. All statistical data analyses were carried out using the Statistical Package for the Social Sciences (SPSS) version 20.0.
  
  
  RESULTS
  Fifteen per cent of patients were identified as sarcopenic. There were no deaths in the study group. Sarcopenia was associated with a significantly increased risk of developing major complications (Grade 3 or greater, OR = 5.41, 95% CI: 1.45-20.15, P = 0.01). Sarcopenia did not predict length of stay, critical care dependency or time to mobilization.
  
  
  CONCLUSIONS
  Sarcopenia, as a marker of frailty, is an important risk factor in surgical patients but difficult to estimate using bedside testing. CT scans, performed for preoperative staging, provide an opportunity to quantify lean muscle mass without additional cost or exposure to radiation and eliminate the inconvenience of further investigations.
authors.affiliation: Department of Surgery, Oxford University Hospitals, Oxford, UK.
authors.forename: K I
authors.initials: KI
authors.lastname: Jones
authors.forename: B
authors.initials: B
authors.lastname: Doleman
authors.forename: S
authors.initials: S
authors.lastname: Scott
authors.forename: J N
authors.initials: JN
authors.lastname: Lund
authors.forename: J P
authors.initials: JP
authors.lastname: Williams
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019412:Anatomy, Cross-Sectional; D003082:Colectomy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D016658:Psoas Muscles / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
keywords: Sarcopenia; complications; computed tomography