Bibliographic Details
| Title: |
Sarcopenia provides extra value outside the PULP score for predicting mortality in older patients with perforated peptic ulcers |
| Authors: |
Yu-Hao Wang, Yu-San Tee, Yu-Tung Wu, Chi-Tung Cheng, Chih-Yuan Fu, Chien-Hung Liao, Chi-Hsun Hsieh, Stewart C. Wang |
| Source: |
BMC Geriatrics, Vol 23, Iss 1, Pp 1-8 (2023) |
| Publisher Information: |
BMC, 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Geriatrics |
| Subject Terms: |
Perforated peptic ulcer, Geriatric, Sarcopenia, PULP score, Geriatrics, RC952-954.6 |
| More Details: |
Abstract Background Perforated peptic ulcer (PPU) remains challenging surgically due to its high mortality, especially in older individuals. Computed tomography (CT)-measured skeletal muscle mass is a effective predictor of the surgical outcomes in older patients with abdominal emergencies. The purpose of this study is to assess whether a low CT-measured skeletal muscle mass can provide extra value in predicting PPU mortality. Methods This retrospective study enrolled older (aged ≥ 65 years) patients who underwent PPU surgery. Cross-sectional skeletal muscle areas and densities were measured by CT at L3 and patient-height adjusted to obtain the L3 skeletal muscle gauge (SMG). Thirty-day mortality was determined with univariate, multivariate and Kaplan–Meier analysis. Results From 2011 to 2016, 141 older patients were included; 54.8% had sarcopenia. They were further categorized into the PULP score ≤ 7 (n=64) or PULP score > 7 group (n=82). In the former, there was no significant difference in 30-day mortality between sarcopenic (2.9%) and nonsarcopenic patients (0%; p=1.000). However, in the PULP score > 7 group, sarcopenic patients had a significantly higher 30-day mortality (25.5% vs. 3.2%, p=0.009) and serious complication rate (37.3% vs. 12.9%, p=0.017) than nonsarcopenic patients. Multivariate analysis showed that sarcopenia was an independent risk factor for 30-day mortality in patients in the PULP score > 7 group (OR: 11.05, CI: 1.03-118.7). Conclusion CT scans can diagnose PPU and provide physiological measurements. Sarcopenia, defined as a low CT-measured SMG, provides extra value in predicting mortality in older PPU patients. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1471-2318 |
| Relation: |
https://doaj.org/toc/1471-2318 |
| DOI: |
10.1186/s12877-023-03946-7 |
| Access URL: |
https://doaj.org/article/441dce66e4534c1a82739ab888e3c63a |
| Accession Number: |
edsdoj.441dce66e4534c1a82739ab888e3c63a |
| Database: |
Directory of Open Access Journals |
