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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 6/2017

Open Access 01-06-2017 | Original Article

The Association of Computed Tomography-Assessed Body Composition with Mortality in Patients with Necrotizing Pancreatitis

Authors: Janneke van Grinsven, Jeroen L. A. van Vugt, Arvind Gharbharan, Thomas L. Bollen, Marc G. Besselink, Hjalmar C. van Santvoort, Casper H. J. van Eijck, Djamila Boerma, for the Dutch Pancreatitis Study Group

Published in: Journal of Gastrointestinal Surgery | Issue 6/2017

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Abstract

Background

Identification of patients with necrotizing pancreatitis at high risk for a complicated course could facilitate clinical decision-making. In multiple diseases, several parameters of body composition are associated with impaired outcome, but studies in necrotizing pancreatitis are lacking.

Methods

A post hoc analysis was performed in a national prospective cohort of 639 patients with necrotizing pancreatitis. Skeletal muscle mass, skeletal muscle density, and visceral adipose tissue were measured at the third lumbar vertebra level (L3) on contrast-enhanced computed tomography (CT) within 10 days after initial admission and 1 month thereafter.

Results

In total, 496 of 639 patients (78%) were included. Overall mortality rate was 14.5%. Skeletal muscle mass and density and visceral adipose tissue on first CT were not independently associated with in-hospital mortality. However, low skeletal muscle density was independently associated with increased mortality in patients ≥65 years (OR 2.54 (95%CI 1.12–5.84, P = 0.028). Skeletal muscle mass and density significantly decreased within 1 month, for both males and females, with a median relative loss of muscle mass of 12.9 and 10.2% (both P < 0.001), respectively. Skeletal muscle density decreased with 7.2 and 7.5% (both P < 0.001) for males and females, respectively. A skeletal muscle density decrease of ≥10% in 1 month was independently associated with in-hospital mortality: OR 5.87 (95%CI 2.09–16.50, P = 0.001).

Conclusion

First CT-assessed body composition parameters do not correlate with in-hospital mortality in patients with necrotizing pancreatitis. Loss of skeletal muscle density ≥10% within the first month after initial admission, however, is significantly associated with increased mortality in these patients.
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Metadata
Title
The Association of Computed Tomography-Assessed Body Composition with Mortality in Patients with Necrotizing Pancreatitis
Authors
Janneke van Grinsven
Jeroen L. A. van Vugt
Arvind Gharbharan
Thomas L. Bollen
Marc G. Besselink
Hjalmar C. van Santvoort
Casper H. J. van Eijck
Djamila Boerma
for the Dutch Pancreatitis Study Group
Publication date
01-06-2017
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 6/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3352-3

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