Psoas Sarcopaenia Outcomes in Elderly Patients After Acute Lower Gastrointestinal Bleeding.

Abstract

Introduction Sarcopaenia has been examined as a predictor of frailty in surgical patients and may predict mortality. The hypothesis of this study is that sarcopaenia is associated with an increased risk of death following an episode of acute lower gastrointestinal bleeding (ALGB). Methods This study included patients admitted with ALGB between January 2017 and June 2022, who underwent cross-sectional imaging (CSI). CSI was accessed via imaging platforms, and the total psoas area (TPA) was calculated at the third lumbar vertebra (L3) by a radiology resident (post-Fellowship of the Royal College of Radiologists(FRCR)) and validated by a consultant radiologist. Clinical, mortality, and demographic data were obtained from the Northern Ireland Electronic Care Record (NIECR). Psoas muscle index (PMI) was calculated using TPA, standardising for height in mm2/m2. Sarcopaenia was defined asPMI<545 mm2/m2for males and <385 mm2/m2for females. Results A total of 103 patients were included. Of these, 32 patients were defined as sarcopaenic (male, n = 20; female, n = 12). There was a statistically significant increase in mortality in the sarcopaenic group(Chi square (1, N = 103 = 7.582, p = 0.005888), odds ratio (OR) of 3.34, 95% confidence interval (CI) of 1.41-7.91). The Kaplan-Meier curve showed a significant decrease in survival probability in combinedmale and female groups (p < 0.001). There was a statistically significant association between sarcopaenic patients and length of hospital stay (LOHS) compared with non-sarcopaenic patients (p < 0.001). Conclusions Sarcopaenia as a predictor of frailty is an important risk factor for all-cause mortality in ALGB. CSI provides an opportunity to identify as well as investigate the aetiology of ALGB. Although radiation risk may limit its use, it should be considered when available.