Determining the Impact of Sarcopenia on Postoperative Complications after Ventral Hernia Repair

Publication date: Available online 15 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Leandra A. Barnes, Alexander Y. Li, Derrick C. Wan, Arash Momeni
BackgroundPostoperative complication following ventral hernia repair (VHR) is a major clinical and financial burden. Preoperative risk assessment is necessary to minimize adverse outcomes following VHR. This study examines the ability of an independent parameter to predict postoperative morbidity following VHR.MethodsA retrospective analysis of 58 patients who underwent VHR via component separation between January 2009 and December 2013 was performed. Preoperative abdominal CT scans were analyzed to assess sarcopenia. Sarcopenia was determined using the Hounsfield unit average calculation (HUAC), a measure of psoas muscle size and density. Sarcopenia was defined as a HUAC score of less than 19.6 using receiver-operating characteristic (ROC) analysis and the Youden index. Multivariate analysis was performed to analyze the association of sarcopenia and postoperative complications.ResultsPreoperative sarcopenia was associated with an increased risk for postoperative complications (odds ratio [OR] 5.3; p=0.04). Preexisting gastrointestinal conditions, such as ulcerative colitis or colon cancer, were associated with an increased risk for postoperative complications (OR 5.7; p=0.05). A significantly higher rate of hernia recurrence (33.3% vs 10.8% [p=0.04]) and renal failure (19% vs 2.7% [p=0.03]) was noted in patients with sarcopenia when compared to patients without sarcopenia.ConclusionsSarcopenia is an independent risk factor for postoperative complications in VHR patients. Assessing sarcopenia using the HUAC score provides an opportunity for the adjustment of perioperative care plans to minimize postoperative complication rates.