PP157 - CORRELATION OF CALF CIRCUMFERENCE AND MUSCULOSKELETAL ULTRASONOGRAPHY IN PATIENT UNDERGOING ELECTIVE CABG.

PP157

CORRELATION OF CALF CIRCUMFERENCE AND MUSCULOSKELETAL ULTRASONOGRAPHY IN PATIENT UNDERGOING ELECTIVE CABG.

S. Pandey^1,*, Y. Mehta², S. Chopra¹, M. K. Singh³, C. Shekhar ², N. Trehan⁴, A. Bhan⁵

¹Clinical Nutrition and Dietetics, ²Institute of Critical Care and Anesthesiology, ³Clinical Research , ⁴CTVS, ⁵Heart Instituted and Cardiac Surgery, Medanta Hospital, Gurugram, India

Rationale: Sarcopenia is a clinically significant predictor of adverse perioperative outcomes, particularly in cardiac surgery patients. Calf circumference (CC) is a simple bedside screening tool, while BMI-adjusted CC has been proposed to enhance diagnostic accuracy. However, their validity against ultrasound-based muscle assessment remains inadequately explored.On Basis of this, we evaluate and compare the diagnostic performance of CC and BMI-adjusted CC in detecting low muscle mass using ultrasound-derived cross-sectional area (CSA) and Y-axis measurements of the rectus femoris muscle.

Methods: In this prospective study, 150 patients undergoing elective CABG were assessed. CC and BMI-adjusted CC were measured using standardized techniques. Sarcopenia was defined using musculoskeletal ultrasonography (MKUS), with CSA and Y-axis as reference standards. Diagnostic performance was evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy with 95% confidence intervals.

Results: The prevalence of sarcopenia was 76.7% by CSA and 15.3% by Y-axis. BMI-adjusted CC demonstrated higher sensitivity than CC against both CSA (86.96% vs. 53.04%) and Y-axis (91.30% vs. 69.57%), indicating superior screening ability. However, specificity was markedly lower for BMI-adjusted CC (CSA: 14.29%; Y-axis: 14.17%), reflecting a higher false-positive rate. In contrast, CC showed moderate sensitivity and specificity, offering a more balanced diagnostic profile. Notably, both measures demonstrated low NPV against CSA but high NPV against Y-axis.

Conclusion: BMI-adjusted CC is a highly sensitive tool suitable for initial screening of low muscle mass but lacks specificity. Standard CC provides a more balanced diagnostic approach. Integration of anthropometric and imaging-based modalities may improve diagnostic accuracy in clinical practice.

Disclosure of Interest: None declared