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. 2021 Apr 23;26(1):36.
doi: 10.1186/s40001-021-00507-9.

Risk factors for surgery-related muscle quantity and muscle quality loss and their impact on outcome

Laura van Wijk  1 , Stijn van Duinhoven  2 , Mike S L Liem  3 , Donald E Bouman  4 , Alain R Viddeleer  5 , Joost M Klaase  2   3
Affiliations

Risk factors for surgery-related muscle quantity and muscle quality loss and their impact on outcome

Laura van Wijk et al. Eur J Med Res. .

Abstract

Background: Surgery-related loss of muscle quantity negatively affects postoperative outcomes. However, changes of muscle quality have not been fully investigated. A perioperative intervention targeting identified risk factors could improve postoperative outcome. This study investigated risk factors for surgery-related loss of muscle quantity and quality and outcomes after liver resection for colorectal liver metastasis (CRLM).

Methods: Data of patients diagnosed with CRLM who underwent liver resection between 2006 and 2016 were analysed. Muscle quantity (psoas muscle index [PMI]), and muscle quality, (average muscle radiation attenuation [AMA] of the psoas), were measured using computed tomography. Changes in PMI and AMA of psoas after surgery were assessed.

Results: A total of 128 patients were analysed; 67 (52%) had surgery-related loss of muscle quantity and 83 (65%) muscle quality loss. Chronic obstructive pulmonary disease (COPD) (P = 0.045) and diabetes (P = 0.003) were risk factors for surgery-related loss of muscle quantity. A higher age (P = 0.002), open resection (P = 0.003) and longer operation time (P = 0.033) were associated with muscle quality loss. Overall survival was lower in patients with both muscle quantity and quality loss compared to other categories (P = 0.049). The rate of postoperative complications was significantly higher in the group with surgery-related loss of muscle quality.

Conclusions: Risk factors for surgery-related muscle loss were identified. Overall survival was lowest in patients with both muscle quantity and quality loss. Complication rate was higher in patients with surgery-related loss of muscle quality.

Keywords: Colorectal liver metastasis; Liver resection; Psoas muscle index; Surgery-related muscle quality loss; Surgery-related muscle quantity loss; Total psoas area.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Impact of surgery-related muscle quantity and quality loss on survival in patients after liver resection for colorectal liver metastasis. a We found no significant difference in overall survival between patients with and without muscle quantity loss, and however, a trend was seen. b Patients with muscle quality loss had a significantly lower survival than patients without muscle quality loss (log-rank test, P = 0.012). c Patients without muscle quantity and quality muscle loss had significantly higher survival than other categories, while patients with both muscle quantity and quality loss had significantly lower survival (log-rank test, P = 0.049)
See this image and copyright information in PMC

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