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Journal of Gastrointestinal Surgery

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01-04-2015 | Original Article

Skeletal Muscle Percentage: A Protective Factor for Postoperative Morbidity in Crohn’s Disease Patients with Severe Malnutrition

Authors: Wei Zhang, Weiming Zhu, Jianan Ren, Lugen Zuo, Xiuwen Wu, Jieshou Li

Published in: Journal of Gastrointestinal Surgery | Issue 4/2015

Abstract

Background

There are no appropriate variables for predicting postoperative morbidity in Crohn’s disease (CD) patients with severe malnutrition. We examined a retrospective cohort to clarify these.

Materials and Methods

Between 2005 and 2013, 138 CD patients with severe malnutrition underwent elective intestinal resection after preoperative management, consisting of nutritional support, abscess drainage, intravenous antibiotics, steroids tapering, and infliximab weaning, as appropriate. The severity of postoperative morbidity (within the first 30 days) was examined according to the Clavien–Dindo classification system.

Results

After a median duration of 26 days of preoperative management, Crohn’s disease activity index (CDAI) and C-reactive protein (CRP) significantly decreased, and body mass index (BMI), skeletal muscle percentage (SMP), body fat percentage (BFP), albumin, prealbumin, and hemoglobin significantly increased (P < 0.001). Postoperative overall morbidities occurred in 28 (20.3 %) patients including 15 (10.8 %) major complications (Clavien–Dindo classification ≥ III). In the multivariate logistic regression analysis, preoperative CRP (P = 0.044, OR 1.156, 95 % CI 1.004–1.331) was a significantly independent risk factor for overall complications, and preoperative SMP (P = 0.002, OR 0.487, 95 % CI 0.307–0.772) and BFP (P = 0.036, OR 0.691, 95 % CI 0.490–0.996) were significantly independent protective factors. Notably, only preoperative SMP (P = 0.002, OR 0.588, 95 % CI 0.422–0.820) was a significantly independent protective factor for major complications, and our threshold of SMP was 24.3 % (P < 0.001, sensitivity 83.7 %, specificity 95.9 %).

Conclusions

Preoperative SMP is a protective factor for postoperative overall and major complications in CD patients with severe malnutrition and deserves further study.

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Title: Skeletal Muscle Percentage: A Protective Factor for Postoperative Morbidity in Crohn’s Disease Patients with Severe Malnutrition
Authors: Wei Zhang
Weiming Zhu
Jianan Ren
Lugen Zuo
Xiuwen Wu
Jieshou Li
Publication date: 01-04-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 4/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-015-2763-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Skeletal Muscle Percentage: A Protective Factor for Postoperative Morbidity in Crohn’s Disease Patients with Severe Malnutrition

Abstract

Background

Materials and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and Methods

Results

Conclusions

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