Resident Internal Medicine West Virginia University Hospital, Ruby Memorial Hospital Morgantown, WV
Yousaf B. Hadi, MD, Yasir Al-Azzawi, MD, Syeda F. Naqvi, MD, George Obeng, MD, Dhairya Lakhani, MD, Ahsan Ullah Khan, MD, Justin T. Kupec, MD, FACG; West Virginia University Hospital, Ruby Memorial Hospital, Morgantown, WV
Introduction: Sarcopenia can be assessed by skeletal muscle depletion and is a marker for frailty that predicts prognosis in multiple diseases. However, its utility in prognosticating patients with acute pancreatitis has not been assessed. Methods: A retrospective cohort study including patients with acute pancreatitis was conducted after IRB approval at our tertiary care university hospital. Adult patients with index episode of acute pancreatitis were included. Sarcopenia was assessed with psoas muscle index measured on the computed tomography scan at index pancreatitis episodes normalized for height and gender. Clinical outcomes including development of severe pancreatitis, walled off necrosis, presentation with pseudocyst at follow up were compared. Analyses were conducted using Chi square, Fisher Exact, and T tests. Results: A total of 217 patients were included. Mean age of participants was 44.99 years (SD: 16.70), and 134 participants (61.8%) were male. Twenty patients fulfilled criteria for sarcopenia (9.2%) while 197 patients (90.8%) were included in the non-sarcopenia group. Gallstones were the most common etiology (24%) followed by alcohol (21.7%). Severity of index episode of pancreatitis did not differ between the sarcopenia and non-sarcopenia groups (p = 0.79). Sarcopenia was associated with higher mean length of stay (7.797 days ± 12.75 vs 15.53 days ± 21.19, p =0.02). Thirteen patients (6.6%) and five patients (25%) presented with pseudocysts at follow up in the non-sarcopenia and sarcopenia groups respectively (p=0.004). Multivariable logistic regression analysis revealed presence of sarcopenia to be an independent predictor of pseudocyst development after adjusting for age and gender (OR: 5.12 95% CI: 1.5-17.42). Discussion: Sarcopenia assessed by psoas muscle index predicts pseudocyst development and length of hospital stay in patients with acute pancreatitis. Prospective studies are needed to explore the prognostic role of this imaging biomarker in acute pancreatitis.
Psoas muscle area measurement for PMI
Disclosures: Yousaf Hadi indicated no relevant financial relationships. Yasir Al-Azzawi indicated no relevant financial relationships. Syeda Naqvi indicated no relevant financial relationships. George Obeng indicated no relevant financial relationships. Dhairya Lakhani indicated no relevant financial relationships. Ahsan Ullah Khan indicated no relevant financial relationships. Justin Kupec indicated no relevant financial relationships.