IDDF2019-ABS-0162 Sarcopenia predicts the need for surgery and correlates with postoperative complications in severe ulcerative colitis patients

Abstract

Background Acute severe ulcerative colitis (ASUC) is always known as a life-threatening condition which requires medical treatment including first-line treatment (intravenous corticosteroids) and rescue treatment (ciclosporin or infliximab) or surgical intervention. Studies demonstrate the prediction of sarcopenia in disease activity of Crohn’s disease, but the prediction value for surgery and postoperative complications in ASUC remains unclear. Methods This study included 168 patients with ASUC from our center. Skeletal muscle area (SMA), visceral fat area (VFA), and subcutaneous fat area (SFA) were assessed using abdominal CT scan by radiologists blinded to the outcome. The definition of sarcopenia was according to a skeletal muscle index of 2/m2 for men and 2/m2 for women. Whether sarcopenia predicted the need for surgery and postoperative complications or not was determined. Results Among 168 patients with ASUC, 54 (32.1%) required surgery and 114 (67.9%) received intravenous corticosteroids or rescue treatment. CT scan showed 121 (72.0%) patients had sarcopenia. Patients with sarcopenia had longer disease duration, more total parenteral nutrition, higher CRP level and lower quality of life. Although patients who required surgery had lower SMA, no significant differences were found in medical and surgical therapy between patients with and without sarcopenia. Patients with postoperative complications had higher preoperative white blood cell level and C-reactive protein, and a higher incidence of sarcopenia. Multivariate analysis showed that sarcopenia (odds ratio, 53.07; 95% confidence interval, 2.79–1010.03; p=0.008) was a negative predictor of postoperative complications in ASUC patients (table 1). Conclusions The prevalence of sarcopenia was high in patients with ASUC. Sarcopenia was not a predictor of surgery, but a risk factor of postoperative complications in severe ulcerative colitis patients.