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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-06

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

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. More... »

PAGES

1000-1008

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-016-3352-3

DOI

http://dx.doi.org/10.1007/s11605-016-3352-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084032018

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28299618


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