Low thoracic muscle radiation attenuation is associated with postoperative pneumonia following partial hepatectomy for colorectal metastasis

Gregory van der Kroft*, David P J van Dijk, Sander S Rensen, Frank H Van Tiel, Bianca de Greef, Malcolm West, Kris Ostridge, Cornelis H C Dejong, Ulf P Neumann, Steven W M Olde Damink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Low skeletal muscle radiation attenuation (SM-RA) is indicative of myosteatosis and diminished muscle function. It is predictive of poor outcome following oncological surgery in several cancer types. Postoperative pneumonia is a known risk factor for increased postoperative mortality. We hypothesized that low SM-RA of the respiratory muscles at the 4th thoracic-vertebra (T4) is associated with postoperative pneumonia following liver surgery.

METHODS: Postoperative pneumonia was identified using prospective infection control data. Computed tomography body composition analysis was performed at the L3-and T4 level to determine SM-RA. Body composition variables were corrected for confounders and related to postoperative pneumonia and admission time by multivariable logistic regression.

RESULTS: Body composition analysis of 180 patients was performed. Twenty-one patients developed postoperative pneumonia (11.6%). Multivariable analysis showed that low T4 SM-RA as well as low L3 SM-RA were significantly associated with postoperative pneumonia (OR 3.65, 95% CI 1.41-9.49, p < 0.01) and (OR 3.22, 95% CI 1.20-8.61, p = 0.02, respectively).

CONCLUSION: Low SM-RA at either the L3-or T4-level is associated with a higher risk of postoperative pneumonia following CLRM resection.

Original languageEnglish
Pages (from-to)1011-1019
Number of pages9
JournalHPB
Volume22
Issue number7
Early online date15 Nov 2019
DOIs
Publication statusPublished - Jul 2020

Keywords

  • BODY-COMPOSITION
  • COMPUTED-TOMOGRAPHY
  • HEALTH
  • MORTALITY
  • PREDICTOR
  • PULMONARY COMPLICATIONS
  • SARCOPENIC OBESITY
  • SKELETAL-MUSCLE
  • SURGERY
  • VISCERAL ADIPOSITY
  • CANCER

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