title: Sarcopenia is an independent predictor of complications following pancreatectomy for adenocarcinoma.
abstract: OBJECTIVE
  Sarcopenia, which is subclinical loss of skeletal muscle mass, is commonly observed in patients with malignancy. The objective of this study is to determine the correlation between sarcopenia and operative complications following pancreatectomy for cancer.
  
  
  METHODS
  A retrospective review of a pancreatectomy database was performed. The Hounsfield Unit Average Calculation (HUAC) of the psoas muscle, a marker of muscle density and fatty infiltration, was measured from preoperative CT scans. Complications were graded and multivariate logistic regression analysis was performed.
  
  
  RESULTS
  One hundred eighteen patients met criteria for analysis; the overall morbidity rate was 78.8% (n = 93). There were 31 (26.3%) patients who met criteria for sarcopenia using the HUAC. When analyzed as a continuous variable, sarcopenia was an independent predictor of major grade III complications, length of stay, intensive care unit admission, delayed gastric emptying, and infectious, gastrointestinal, pulmonary, and cardiac complications.
  
  
  CONCLUSIONS
  These data suggest that sarcopenia as measured with the HUAC, a value that can be obtained from a preoperative CT scan, is a significant independent predictor of surgical outcome and can be used to improve patient selection and informed consent prior to pancreatectomy in patients with cancer.
authors.affiliation: Department of Surgery, Division of Surgical Oncology and Endocrine Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Savita
authors.initials: S
authors.lastname: Joglekar
authors.forename: Aeen
authors.initials: A
authors.lastname: Asghar
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Mott
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Johnson
authors.forename: Anna M
authors.initials: AM
authors.lastname: Button
authors.forename: Eve
authors.initials: E
authors.lastname: Clark
authors.forename: James J
authors.initials: JJ
authors.lastname: Mezhir
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D001803:Blood Transfusion; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007582:Jejunostomy; D007902:Length of Stay; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D055948:Sarcopenia / Q000150:complications*
keywords: complications; pancreatectomy; pancreatic cancer; sarcopenia