P508 Sarcopenia is associated with increased rates of infectious post-operative complications in Crohn’s disease patients
Simpson, K.(1)*;Inniss, S.(2);Fragkos, K.C.(1);Wood, C.P.J.(1);Smith, A.(2);Rahman, F.Z.(1);
(1)University College London Hospitals NHS Foundation Trust, Gastrointestinal Services, London, United Kingdom;(2)University College London, Eastman Dental Institute, London, United Kingdom;
Background
More than one fifth of Crohn’s disease patients will require surgery within 5 years of diagnosis, rising to over 90% throughout their lifetime. Sarcopenia is defined as a disease process of skeletal muscle decline in mass, function, and physical performance. Emerging evidence suggests sarcopenia may be implicated with Crohn’s disease severity and poorer outcomes. Several sarcopenia assessment tools exist with varying accuracy, however CT or MR images at the level of the third lumbar vertebra (L3) can reliably predict whole-body composition. Our aim was to assess the prevalence of sarcopenia via L3 scores in pre-operative Crohn’s disease patients and examine its impact on post-operative outcomes.
Methods
This single-centre, retrospective study collected data from 95 Crohn’s disease patients undergoing surgery between 2015-2021 and followed up for 12 months. Pre-operative baseline characteristics and post-operative outcomes were recorded immediately after surgery and at 30 days, 1, 6 and 12 months. Infectious and non-infectious complications were recorded, including but not limited to: abscess, collection, wound site infection, anastomotic leak, venous thromboembolism, haemorrhage. Sarcopenia was assessed from CT and MR imaging at the level of L3 within 3 months of surgery, and was defined as per the Martin et al. equation.
Results
Of 58 Crohn’s disease patients with pre-operative imaging, sarcopenia was prevalent at 74.1% (43/58). Pre-operative Harvey-Bradshaw Index was significantly higher in those with sarcopenia (sarcopenic group: 8, non-sarcopenic: 4, p<0.001). In addition, anaemia adjusted for gender was more prevalent in the sarcopenic group versus non-sarcopenic (56.1% [23/41] versus 25% [3/15], p=0.058). Sarcopenic patients experienced higher rates of infective complications within 30 days of surgery (22.5% [9/40] versus 0, p=0.052).
Conclusion
The prevalence of sarcopenia is higher in Crohn’s disease patients undergoing surgery than first thought and may be implicated in disease severity. Our study found that sarcopenia is associated with increased rates of infective post-operative complications. Further studies are required to corroborate our findings and identify appropriate interventions for sarcopenia. In conclusion, sarcopenia in Crohn’s disease may reflect a phenotype of aggressive disease implicated with worse post-operative outcomes.