Psoas muscle density predicts elective colorectal surgical outcomes more accurately than psoas muscle area or indexed area - 29/03/25
, Douglas Stupart a, c, David Watters a, c
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Abstract |
Background |
CT measurements of psoas muscle density (PMD) and area (PMA) (with or without indexing to height-squared or body-surface-area) are used interchangeably as sarcopenia measures - it is unknown which best correlates with surgical risk.
Objectives |
1.Determine the correlation between psoas muscle density, area, and indexed area;
2.Identify which psoas measures most strongly associated with surgical outcomes
Design |
The University Hospital Geelong Colorectal database included all patients who underwent elective colorectal surgery from 2007 to 2014 (minimum five-years follow-up). Pre-operative CT scans were reviewed, psoas measures correlated with each other and with outcomes.
Setting |
University Hospital Geelong is a regional referral hospital in Victoria, Australia.
Participants |
This database listed 552 patients, 120 were excluded as pre-operative CT-films were not accessible, leaving 432 patients included.
Exposure |
Psoas muscle density, area, and area indexed by height-squared and body-surface-area.
Measurements |
Pearson correlations investigated correlations between psoas muscle measures. Logistic regression and ROC-analysis investigated each psoas measures association with peri‑operative morbidity. Kaplan-Meier survival-analysis investigated the association of each psoas measure with long-term survival.
Results |
Mean age was 70.4 years, 41 % were female.
Psoas muscle density correlated poorly with area (R2=0.15). Unindexed psoas muscle area correlated well with area indexed by height-squared (R2=0.950) and body-surface-area (R2=0.938).
Long-term survival was associated with psoas muscle density (HR1.515(95 %CI 1.062–2.161)) and area (HR1.886(95 %CI 1.322–2.692)).
Increasing psoas muscle density (reduced sarcopenia) was associated with decreased major-complications (OR0.963(95 %CI 0.938–0.989)) and peri‑operative mortality (OR0.903(95 %CI 0.847–0.962)), with ROC-curve AUC=0.829 indicating an accurate test. There was no association between psoas muscle area and major-complications (OR1.000(95 %CI 1.000–1.000)), nor peri‑operative mortality (OR1.000(95 %CI 0.999–1.001)), with ROC-curves AUC=0.507–0.521.
Indexed area measures were not associated with outcomes.
Conclusions |
Psoas muscle density and area did not correlate. Both were associated with long-term survival, but only density was associated major-complications and mortality. Indexing removed the correlation of area with long-term survival.
Le texte complet de cet article est disponible en PDF.Keywords : Sarcopenia, Psoas-muscle, Surgery, Colorectal, Operative-risk
Plan
Vol 14 - N° 3
Article 100037- juin 2025 Retour au numéro
Article précédent
- Psoas muscle density predicts elective colorectal surgical outcomes more accurately than psoas muscle area or indexed area
- Louis Scarrold, Douglas Stupart, David Watters
- Maximising inclusivity in care home research: Lessons learned from the AFRI-c randomised controlled trial
- Laurel Campbell-Smith, Sophie Rees, Jane Sprackman, Karen Sargent, Alastair D Hay, Rachel CM Brierley
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