2130. Impact of Sarcopenic Obesity on Surgical Site Infection After Gastric Cancer Surgery: A Retrospective Study of 1,038 Patients

Abstract

BackgroundRecent studies have shown that body composition is an important factor affecting surgical outcomes. In this study, we investigate the effect of sarcopenic obesity on surgical site infection (SSI) after gastric cancer surgery.MethodsWe performed a retrospective cohort study of 1,038 patients who underwent gastric cancer surgery between January 2015 and December 2015 at tertiary care hospital in Seoul, Korea. Visceral fat area (VFA) and total abdominal muscle area (TAMA) were assessed at preoperative staging computed tomography scan. Sarcopenic obesity was defined as high VFA/TAMA ratio and receiver operating characteristic (ROC) curves were used to determine the threshold of VFA/TAMA ratio to predict SSI after gastric cancer surgery. Multivariate logistic regression analysis was used to identify independent risk factors for SSI.ResultsOf the 1,038 eligible patients, 58 patients (5.6%) developed SSI. The average value of VFA/TAMA is 2.69 ± 1.43 in non-SSI group and 3.38 ± 1.34 in SSI group (P < 0.001). By using ROC curve, the cut-off value of VFA/TAMA to predict SSI is 3 (AUC 0.653; sensitivity 67%, specificity 61%). Multivariate analysis indicated that smoking (odds ratio (OR), 1.99; 95% confidence interval (CI), 1.1–3.62; P = 0.024), total gastrectomy (OR, 2.45; 95% CI, 1.36–4.42; P = 0.003), stage III, IV cancer (OR, 2.58; 95% CI, 1.44–4.63; P = 0.001) and sarcopenic obesity (OR, 2.85; 95% CI, 1.6–5.06; P < 0.001) were independent risk factors for SSI after gastric cancer surgery. In sarcopenic obesity patients, the incidence rate of Clavien–Dindo score IIIa or higher postoperative complication (7.1% vs. 4%; P = 0.028), mean days of postoperative hospital stay (8.42 ± 7.93 vs. 7.12 ± 3.54; P < 0.001), and the incidence rate of delayed complications requiring re-admission within 30 days (6.1% vs. 2.7%; P = 0.007) were statistically significantly higher than those of the nonsarcopenic obesity patients.ConclusionSarcopenic obesity is an independent risk factor for the development of SSI after gastric cancer surgery. In addition, sarcopenic obesity is associated with high incidence of postoperative complication, prolongation of postoperative hospital stay and an increase of re-admission rate within 30 days.Disclosures All authors: No reported disclosures.