Gregory van der Kroft1, David P J van Dijk2, Sander S Rensen3, Frank H Van Tiel4, Bianca de Greef5, Malcolm West6, Kris Ostridge7, Cornelis H C Dejong8, Ulf P Neumann9, Steven W M Olde Damink8. 1. Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, Uniklinikum RWTH-Aachen, European Surgical Center Aachen Maastricht (ESCAM), Aachen, Germany. Electronic address: gregory.kroft@gmail.com. 2. Department of Surgery, Maastricht University Medical Center, Department of Surgery, European Surgical Center Aachen Maastricht (ESCAM), Maastricht, the Netherlands. 3. Department of Surgery, Maastricht University Medical Center, Department of Surgery, European Surgical Center Aachen Maastricht (ESCAM), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands. 4. Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, the Netherlands. 5. Department of Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Center, Maastricht, the Netherlands. 6. Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. 7. Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. 8. Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, Uniklinikum RWTH-Aachen, European Surgical Center Aachen Maastricht (ESCAM), Aachen, Germany; Department of Surgery, Maastricht University Medical Center, Department of Surgery, European Surgical Center Aachen Maastricht (ESCAM), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands. 9. Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, Uniklinikum RWTH-Aachen, European Surgical Center Aachen Maastricht (ESCAM), Aachen, Germany; Department of Surgery, Maastricht University Medical Center, Department of Surgery, European Surgical Center Aachen Maastricht (ESCAM), Maastricht, the Netherlands.
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.
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.
Authors: S W M Olde Damink; Christian S Bruells; Gregory van der Kroft; Sebastian Johannes Johannes Fritsch; S S Rensen; Steffen Wigger; Christian Stoppe; Andreas Lambertz; Ulf Peter Neumann Journal: BMJ Open Date: 2021-11-16 Impact factor: 2.692
Authors: Franziska Alexandra Meister; Georg Lurje; Suekran Verhoeven; Georg Wiltberger; Lara Heij; Wen-Jia Liu; Decan Jiang; Philipp Bruners; Sven Arke Lang; Tom Florian Ulmer; Ulf Peter Neumann; Jan Bednarsch; Zoltan Czigany Journal: Cancers (Basel) Date: 2022-01-30 Impact factor: 6.639