Association of Skeletal Muscle, Body Fat and Frailty With Prolonged Length of Hospital Stay Following Colectomy for Adenocarcinoma: A Pilot Case-Control Study.

Physical fitness is well-known to be associated with health outcomes. This pilot study examined the impact of different measures of fitness on length of stay following colectomy. A case-control study was designed to evaluate the effect of skeletal muscle mass, body fat, and frailty measures on post-operative length of stay (LOS). A simple random sample of 50 patients in each arm was selected based on prolonged LOS. Binary logistic regression analysis was performed to determine associations between each covariate and LOS. After exclusions, 40 cases and 36 controls were included in the analysis. Frailty, as determined by weight loss and the Modified Frailty Index was not associated with prolonged LOS (p = 0.060 and p = 0.469). Cross-sectional muscle area (OR: 0.994, 95% CI: 0.989-0.999, p = 0.029) and skeletal muscle index (OR: 0.981, 95% CI: 0.965-0.996, p = 0.015) were associated with decreased LOS. Measures of body fat, as well as muscle-to-body fat ratios were not associated with LOS. These results suggest that body fat may be less influential than skeletal muscle when predicting post-operative outcomes. This pilot study warrants further investigation with a larger number of patients to identify cut-off values with which to provide targeted prehabilitation.