You have accessJournal of UrologyImaging/Radiology III1 Apr 2014MP12-15 SARCOPENIA AS MEASURED BY PSOAS AND ERECTOR SPINAE MUSCLE DENSITY IS ASSOCIATED WITH HIGHER INCIDENCE OF POSTOPERATIVE COMPLICATIONS FOLLOWING RADICAL CYSTECTOMY FOR BLADDER CANCER Mark Currin, Austin DeRosa, James Rosoff, John Roebel, Matthew Jaenicke, Andrew Hardie, and Sandip Prasad Mark CurrinMark Currin More articles by this author , Austin DeRosaAustin DeRosa More articles by this author , James RosoffJames Rosoff More articles by this author , John RoebelJohn Roebel More articles by this author , Matthew JaenickeMatthew Jaenicke More articles by this author , Andrew HardieAndrew Hardie More articles by this author , and Sandip PrasadSandip Prasad More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.450AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sarcopenia, an objective measurement of frailty, has been associated with poor outcomes in malignancy, including lung, gastrointestinal, and breast cancers. This study examines the relationship between sarcopenia and postoperative complications in patients undergoing radical cystectomy for bladder cancer. METHODS 92 consecutive patients who underwent radical cystectomy from November 2008 to July 2013 were identified from a prospectively collected institutional database. Demographic, staging, and treatment characteristics were identified along with postoperative complications as defined by the American College of Surgeons National Surgery Quality Improvement Program, within 90 day follow-up. Using preoperative CT scans, regions of interest were drawn around the psoas and erector spinae (ES) muscular compartments, and the density was recorded from the average of the measurements bilaterally by a genitourinary radiologist blinded to postoperative outcome. Student's t-test and the ANOVA test were used to compare muscle densities across categorical variables. Linear regression was used to analyze continuous variables. RESULTS There were 190 complications identified in 75 patients (81.5%). Psoas muscle density correlated moderately with ES muscle density (r2 = 0.39, p <0.0001), and measurements of psoas and erector spinae muscle densities were found to be parametrically distributed. Both psoas and ES density correlated with age (r2 = 0.11, p = 0.001 and r2 = 0.25, p <0.0001 respectively). While psoas muscle density did not correlate with total complications, ES density was associated with a higher overall incidence of complications (p = 0.004). Specifically, lower psoas muscle density was associated with deep venous thrombosis, pulmonary embolism (PE)and wound infection, while lower ES density was associated with prolonged postoperative intubation, reintubation, PE and transfusion (p < 0.05 for all). CONCLUSIONS Sarcopenia is associated with a higher incidence of postoperative complications in patients undergoing radical cystectomy for bladder cancer. Preoperative psoas and ES density measurement may be helpful to identify those patients at greater risk of major post-operative complications. Complication Events Psoas (p-value) Erector Spinae (p-value) Ileus 27 0.210 0.688 Pneumonia 3 0.877 0.294 UTI 41 0.347 0.654 Wound infection 10 0.017 0.549 Intubation > 24h 4 0.352 0.007 Reintubation 3 0.928 0.002 PE 5 0.026 0.139 DVT 8 0.013 0.399 Stroke 1 0.367 0.468 MI 4 0.271 0.196 Cardiac arrest 0 N/A N/A Transfusion > 4U in 72h 7 0.176 0.028 Urine leak 2 0.622 0.657 Sepsis 8 0.348 0.071 A-fib/dysrhythmia 16 0.432 0.216 Wound dehiscence 5 0.636 0.214 Acute renal failure 23 0.426 0.942 Reoperation 10 0.562 0.094 Readmission < 30 days 10 0.431 0.989 Death 3 0.318 0.99 Total complications 190 0.358 0.004 Any complication 75 0.106 0.173 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e111 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Mark Currin More articles by this author Austin DeRosa More articles by this author James Rosoff More articles by this author John Roebel More articles by this author Matthew Jaenicke More articles by this author Andrew Hardie More articles by this author Sandip Prasad More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...