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Sarcopenia is a Predictor of Surgical Morbidity in Inflammatory Bowel Disease

Pedersen, Mark MD; Cromwell, John MD; Nau, Peter MD, MS

doi: 10.1097/MIB.0000000000001166
Original Clinical Articles

Background: Sarcopenia is associated with an increased risk of operative morbidity and mortality. The impact of sarcopenia in inflammatory bowel disease (IBD) has not been evaluated. This study assessed the role of sarcopenia on operative outcomes in IBD.

Methods: A retrospective review of American College of Surgeons National Surgical Quality Improvement Program data of patients with IBD was completed. Records were abstracted for comorbidities and perioperative complications. The Hounsfield unit average calculation was used from preoperative computed tomography (CT). Criteria for sarcopenia were based on the lowest 25th percentile. Complications were graded using the Clavien–Dindo classification system. Statistical analysis was completed using SAS.

Results: There were 178 patients included. Sarcopenic patients were more likely to be older (P = 0.001), have hypertension (odds ratio = 2.23), and be diabetic (5.27). In those patients younger than 40 years, sarcopenia was an independent predictor of complications. This subset was significantly more likely to have a normal or elevated body mass index.

Conclusions: In this population, the average age of sarcopenic patients is increased from those who do not meet criteria. Among patients younger than 40 years, sarcopenia affects surgical outcomes. Assessment of sarcopenia can be used to improve preoperative management and describe risks before surgery in patients with IBD.

Article first published online 9 june 2017.

The University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Address correspondence to: Peter Nau, MD, MS, 4628 JCP, 200 Hawkins Drive, Iowa City, IA 52242-1086 (e-mail:

The authors have no conflict of interest to disclose.

Received February 23, 2017

Accepted April 25, 2017

© Crohn's & Colitis Foundation
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