SARCOPENIA, MYOSTEATOSIS, AND FRAILTY PARAMETERS TO PREDICT ADVERSE OUTCOMES IN PATIENTS UNDERGOING EMERGENCY LAPAROTOMY: PROSPECTIVE OBSERVATIONAL MULTICENTRE COHORT STUDY brittany.park09@gmail.com

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SARCOPENIA, MYOSTEATOSIS, AND FRAILTY PARAMETERS TO PREDICT ADVERSE OUTCOMES IN PATIENTS UNDERGOING EMERGENCY LAPAROTOMY: PROSPECTIVE OBSERVATIONAL MULTICENTRE COHORT STUDY

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Andrew MacCormick andrewmaccormick@auckland.ac.nz Te Whatu Ora Health New Zealand Surgery Auckland New Zealand

 

 

 

New Zealand

Oral or Poster

Functional compromise contributes significantly to adverse outcomes after emergency laparotomy. Sarcopenia, defined as reduced muscle strength and quantity, has been seldom assessed in this setting. This study examined functional compromise using sarcopenia, myosteatosis, and frailty parameters, and evaluated impacts on functional and patient-centred outcomes.

Patients aged ≥55 years who underwent emergency laparotomy and preoperative CT at two New Zealand hospitals (Feb 2022–Oct 2023) were included in a prospective database. Sarcopenia was measured using the SARC-F questionnaire, isokinetic dynamometry for grip strength, and skeletal muscle quantity on CT. Myosteatosis was determined using CT, and frailty assessed via the Clinical Frailty Scale. Predictors for rehabilitation admission, days alive and out of hospital at 90 days (DAOH-90), and risk of not returning home were analysed using relative risk and proportional means regression. Secondary outcomes included 3- and 6-month mortality and inpatient morbidity (Clavien–Dindo classification).

Of 101 patients, 21.6% had sarcopenia, 34.7% myosteatosis, and 24.8% were living with frailty. Muscle strength parameters (low grip strength and positive SARC-F) showed significant relationships with primary outcomes. Low grip strength was most predictive for rehabilitation (adjusted RR 5.48, 95% CI 2.03–14.82), and a positive SARC-F for not returning home (adjusted RR 8.26, 95% CI 1.81–37.76). Low muscle quantity showed no association. Frailty was most associated with reduced DAOH-90 (−13.4%, 95% CI −24.3% to −0.8%). Sarcopenia and low grip strength predicted 3- and 6-month mortality.

Sarcopenia and frailty are key determinants of functional compromise after emergency laparotomy. Muscle strength is more important than mass and measurable without imaging.