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Sarcopenia, assessed by psoas muscle area, is significantly associated with adverse outcomes, including increased ICU admissions, prolonged hospital stays, and elevated in-hospital mortality, in patients with sepsis due to acute cholecystitis.

The following is a summary of “Can sarcopenia predict poor prognosis of sepsis due to acute cholecystitis?,” published in the November 2023 issue of Emergency Medicine by Kim, et al.

For a study, researchers sought to investigate the association between sarcopenia, as determined by the psoas muscle area, and the prognosis of sepsis stemming from acute cholecystitis, focusing on early prognosis prediction to formulate effective treatment plans.

Conducted as a retrospective single-center observational study, the research involved adult patients diagnosed with sepsis due to acute cholecystitis who presented at the emergency department from January 2016 to December 2021. Measurements of the psoas muscle area at the L3 level were taken bilaterally, and the psoas muscle index (PMI) adjusted by the patient’s height was calculated. Sarcopenia was defined by specific PMI values: PMI < 423 mm²/m² for males and < 269 mm²/m² for females. The primary outcome was in-hospital mortality, while secondary outcomes included ICU admission, length of hospital stay (LOS), and 14-day mortality.

A cohort of 374 patients was categorized into either the sarcopenic group (94 patients) or the non-sarcopenic group (280 patients) based on the established PMI thresholds. The findings demonstrated a significant association between sarcopenia and ICU admission, with an odds ratio (OR) of 1.98 and a 95% CI ranging from 1.05 to 3.76. Furthermore, a substantial correlation was identified between sarcopenia and in-hospital mortality, as evidenced by an OR of 6.40 and a 95% CI from 1.13 to 36.09. Additionally, patients in the sarcopenic group had a median LOS of 11.5 days, while those in the non-sarcopenic group had a median LOS of 8 days, emphasizing the detrimental impact of sarcopenia on patient outcomes.

The study illuminated a pronounced association between sarcopenia and unfavorable clinical outcomes in patients diagnosed with sepsis due to acute cholecystitis. Specifically, sarcopenia was significantly linked to heightened ICU admissions, extended hospital stays, and increased in-hospital mortality rates. Given these insights, early evaluation of sarcopenia in sepsis patients could offer valuable prognostic information, aiding clinicians in devising more efficacious treatment plans and care strategies.

Source: sciencedirect.com/science/article/abs/pii/S073567572300431X