PP311 - PREOPERATIVE PSOAS MUSCLE INDEX AS AN INDEPENDENT PREDICTOR OF POSTOPERATIVE MORBIDITY IN COLORECTAL SURGERY: A LARGE-SCALE RETROSPECTIVE STUDY

PP311

PREOPERATIVE PSOAS MUSCLE INDEX AS AN INDEPENDENT PREDICTOR OF POSTOPERATIVE MORBIDITY IN COLORECTAL SURGERY: A LARGE-SCALE RETROSPECTIVE STUDY

C. Y. BOZTUG¹, F. D. AVLAR^2,*, P. ARI¹, S. DEMİRER¹

¹GENERAL SURGERY, ANKARA UNIVERSITY FACULTY OF MEDICINE, ²GENERAL SURGERY, ANKARA UNIVERSITY FACULTY OF MEDICINE, ANKARA, Türkiye

Rationale: This retrospective study aimed to evaluate the impact of the preoperative L3 Psoas Muscle Index(PMI),calculated from CT images,along with BMI,preoperative albumin,Hb and CRP levels,on postoperative complications,ICU stay and hospital length of stay(LOS) in patients undergoing colorectal surgery at Ankara University,General Surgery Department between 2020 and 2025.

Methods: Of 619 screened,489 colorectal surgery patients were included(right/left hemicolectomy,anterior/low anterior resection,segmental colectomy, abdominoperineal resection).PMI was calculated at L3 (cm²/m²).Low PMI was defined using sex-specific cut-offs(<3.92 F, <6.36 M cm²/m²). Sarcopenia was radiologically defined.Complications were graded by Clavien–Dindo.Univariate and multivariate logistic regression analyses identified independent predictors of postoperative morbidity.

Results: Mean age 62.3±14.0(57.8% male).Complications 16.2%; mortality 3.9%.Univariate:albumin(OR 0.91,p<0.001),CRP(OR 1.006,p<0.001),Hb(OR 0.86, p=0.008),PMI (OR 0.82,p<0.001)were significant. Low PMI increased risk 2.24-fold (p=0.002).Sarcopenic females had higher morbidity(37.3% vs 10.5%).LOS/ICU stay were longer(p<0.001).Multivariate:albumin(OR 0.94,p=0.028)and PMI(OR 0.86, p=0.022)were independent.

Conclusion: Preoperative PMI is a strong,independent predictor of colorectal surgery complications.A sex-specific disparity was found:sarcopenia in females increased morbidity 3.5-fold(37.3%vs10.5%).Albumin (OR 0.94,p=0.028)and PMI(OR 0.86,p=0.022)independently predicted outcomes,highlighting the need for integrated biochemical and morphological assessment.These findings support CT-based risk stratification.Identifying sarcopenic patients,especially females and those with hypoalbuminemia,offers a window for targeted nutritional optimization through immunonutrition and high-protein intake.

Disclosure of Interest: None declared