PP307 - SKELETAL MUSCLE DEPLETION AND GLIM-DEFINED MALNUTRITION PROVIDE COMPLEMENTARY RISK STRATIFICATION AFTER LIVER RESECTION

PP307

SKELETAL MUSCLE DEPLETION AND GLIM-DEFINED MALNUTRITION PROVIDE COMPLEMENTARY RISK STRATIFICATION AFTER LIVER RESECTION

L. PEREZ SANTIAGO^1,*, I. Mora-Oliver², M. Garcés-Albir ^2,3, E. Muñoz-Forner^2,4, L. Sabater-Ortí^2,5, D. Dorcaratto^2,3

¹Department of General and Digestive Surgery, Hospital Clinico Universitario. INCLIVA Biomedical Research Institute, Colorectal Surgery Unit, ²Department of General and Digestive Surgery, Hospital Clinico Universitario. INCLIVA Biomedical Research Institute, Liver-Biliary and Pancreatic Surgery Unit, ³Department of Anatomy, University of Valencia, ⁴Department of Surgery, University of Valencia, ⁵Department of Surgery, University of Valencia, Valencia, Spain

Rationale: Preoperative nutritional assessment in liver surgery remains heterogeneous. Whether computed tomography–derived muscle mass and Global Leadership Initiative on Malnutrition (GLIM) criteria provide complementary prognostic information for postoperative morbidity warrants evaluation.

Methods: Retrospective observational study including adult patients undergoing elective liver resection for benign and malignant diseases between 2017 and 2021. Skeletal muscle index (SMI) was quantified on preoperative computed tomography. Malnutrition was diagnosed according to GLIM criteria. Postoperative complications were graded using the Clavien–Dindo classification and the Comprehensive Complication Index (CCI). Multivariable logistic regression identified independent predictors.

Results: A total of 253 patients were analyzed. Low SMI independently predicted overall postoperative complications (OR 2.23, 95% CI 1.14–4.38; p=0.02) and severe morbidity defined as Clavien–Dindo ≥III (OR 4.28, 95% CI 2.76–10.40; p=0.001). GLIM-defined malnutrition independently predicted severe complications defined as CCI ≥26.2 (OR 2.95,95% CI 1.44-6.06; p=0,003). The multivariable model showed moderate discrimination for overall morbidity (AUC 0.74) and good discrimination for severe complications defined by Clavien–Dindo (AUC 0.83).

Conclusion: Computed tomography–derived muscle depletion and GLIM-defined malnutrition identify complementary dimensions of postoperative risk after liver resection. While reduced SMI is associated with severe complications, GLIM-defined malnutrition captures patients with a higher cumulative morbidity burden. Multidimensional nutritional assessment may therefore enhance perioperative risk stratification.

Disclosure of Interest: None declared