Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Tomberger, A.
The influence of gender on frailty syndrome in surgical patients undergoing major hepatic resection
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 64
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Wagner Doris
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- Abstract:
- Introduction: Sarcopenia is widely used as a surrogate for the frailty syndrome. The prevalence of frailty among surgical patients is one of the most limiting factors for their postoperative outcome. No study on the progression or reversal of frailty after surgery exists until now. We aimed to depict the course of muscle mass as surrogate for frailty in a cohort of patients undergoing major hepatic resections. Methods: Records of patients who underwent hepatic resection in our institution in between 2005-2016 were reviewed and frailty was defined as sarcopenia using the skeletal muscle index (SMI) preoperatively, 6 months and 12 months after operation. Threshold values for sarcopenia were SMI less than 41 cm2/m2 for women, SMI less than 43 cm2/m2 for men with BMI less than 25 kg/m2, and SMI less than 53 cm2/m2 for men with BMI of 25 kg/m2 or greater. Results: 966 patients (female: 51.4%, male: 48.6%) were included, pre and postoperative CT scans were available from 920 patients (95.2%). Median age was 66 years (35-87), 62% had major hepatectomies. The SMI differed significantly between men and women and decreased significantly throughout the follow up (preoperative SMI: 23.55± 19.15 cm2/m2, 6 months: 18.31±7.3 cm2/m2, 12 months: 13.23±18.41 cm2/m2 p=0.001). This decrease was more pronounced in men as compared to women (men: preoperative SMI: 25.54± 17.31 cm2/m2, 6 months: 20.17± 13.45 cm2/m2, 12 months: 14.36± 12.23 cm2/m2; women: preoperative SMI: 21.71± 13.25 cm2/m2, 6 months: 16.58± 11.32 cm2/m2, 12 months: 12.18± 14.76 cm2/m2, p=0.0001). Postoperative complications did not differ between male and female patients neither did the length of stay, ICU stay or preoperative comorbidities, age and disease severity (all p>0.5). Discussion: Although women had lower preoperative sceletal muscle mass, they seem to recover better as compared to men. The increase in frailty syndrome overall in the patients requires close further investigations and monitoring.