Journal of cancer research and therapeutics · 2025
Body composition in CT as a predictor of major post-operative complications in patients undergoing definitive surgery for intestinal fistulas.
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Wang Yizhe, Li Jie, Wen Puzheng, Wang Lixue, Zheng Zhuozhao
Аннотация
BACKGROUND: Managing intestinal fistulas is complex and challenging due to the development of postoperative complications. It is essential to evaluate the effects of computed tomography (CT) body composition imaging biomarkers on major postoperative complications in these patients following definitive surgery.
METHODS: A total of 88 patients with intestinal fistula, who underwent definitive surgery were retrospectively reviewed. Each body composition index was calculated by dividing the cross-sectional area of the adipose or muscle tissue at the level of the third lumbar vertebra, as identified on a preoperative CT scan, by the square of the height. Postoperative complications were scored according to the Clavien-Dindo classification.
RESULTS: Sixteen out of the 88 patients (18.08%) had major postoperative complications. In the univariate analysis, lower quadratus lumborum index (QLI; P = 0.047) and quadratus lumborum areas ([QLA]/body mass index [BMI]; P = 0.023), higher C-reactive protein (CRP; P = 0.036), longer length of stay (LOS; P = 0.002), and fewer preoperative admission histories (P = 0.049), were identified as risk factors. In the multivariable regression analysis, QLI (P = 0.011; odds ratio [OR] = 0.383) and LOS (P = 0.012; OR = 1.006) were identified as independent risk factors for major postoperative complications. Furthermore, QLI, QLA/BMI, CRP, LOS, sex, and age showed the highest area under the curve of 0.815, with a specificity and sensitivity of 64.8% and 93.8%, respectively (P < 0.001).
CONCLUSION: Patients with lower QLI and QLA/BMI, longer LOS, and higher CRP were prone to have major postoperative complications.
METHODS: A total of 88 patients with intestinal fistula, who underwent definitive surgery were retrospectively reviewed. Each body composition index was calculated by dividing the cross-sectional area of the adipose or muscle tissue at the level of the third lumbar vertebra, as identified on a preoperative CT scan, by the square of the height. Postoperative complications were scored according to the Clavien-Dindo classification.
RESULTS: Sixteen out of the 88 patients (18.08%) had major postoperative complications. In the univariate analysis, lower quadratus lumborum index (QLI; P = 0.047) and quadratus lumborum areas ([QLA]/body mass index [BMI]; P = 0.023), higher C-reactive protein (CRP; P = 0.036), longer length of stay (LOS; P = 0.002), and fewer preoperative admission histories (P = 0.049), were identified as risk factors. In the multivariable regression analysis, QLI (P = 0.011; odds ratio [OR] = 0.383) and LOS (P = 0.012; OR = 1.006) were identified as independent risk factors for major postoperative complications. Furthermore, QLI, QLA/BMI, CRP, LOS, sex, and age showed the highest area under the curve of 0.815, with a specificity and sensitivity of 64.8% and 93.8%, respectively (P < 0.001).
CONCLUSION: Patients with lower QLI and QLA/BMI, longer LOS, and higher CRP were prone to have major postoperative complications.