O004 - RAPID IN-HOSPITAL SKELETAL MUSCLE LOSS IN SEVERE ACUTE PANCREATITIS: A PROSPECTIVE BEDSIDE ULTRASOUND STUDY

O004

RAPID IN-HOSPITAL SKELETAL MUSCLE LOSS IN SEVERE ACUTE PANCREATITIS: A PROSPECTIVE BEDSIDE ULTRASOUND STUDY

V. Teterina^1,*, L. Markulan¹, Y. Susak¹

¹Department of Surgery with a Course in Hepatobiliary and Vascular Surgery, Bogomolets National Medical University, Kyiv, Ukraine

Rationale: Severe acute pancreatitis induces systemic inflammation and hypercatabolism, leading to early skeletal muscle loss (SML) and nutritional risk. Data on early SML dynamics and clinical relevance remain limited.

Methods: A prospective observational study included 28 patients with severe acute pancreatitis complicated by infected necrosis and persistent organ failure. Rectus femoris cross-sectional area was measured using a standardized bedside ultrasound (US) protocol at predefined time points during hospitalization. Relative SML and daily SML rate were calculated from these measurements. Body weight changes were recorded but interpreted cautiously due to fluid shifts. Clinical data included C-reactive protein (CRP), APACHE II score, nutritional support route and in-hospital outcomes. Associations were assessed using non-parametric tests and Spearman correlation.

Results: Among patients with serial US measurements (n = 26), median age was 45.5 years (IQR 36–53). Median SML reached 19.5% (IQR 16.1–24.5), and median daily SML rate was 0.50% (IQR 0.38–0.60). SML was evident early during hospitalization despite nutritional support. Median admission CRP was 173 mg/L (IQR 157–193). Daily SML rate correlated with CRP (Spearman ρ = 0.46, p = 0.018) and body weight decline (ρ = 0.52, p = 0.006). Greater SML was associated with older age (ρ = 0.448, p = 0.022) and higher admission APACHE II score (median 14.5, IQR 12–17; ρ = 0.411, p = 0.037). No association was observed with the nutritional support route.

Conclusion: Severe acute pancreatitis complicated by infected necrosis is associated with substantial SML occurring early during hospitalization. Greater muscle loss is associated with higher inflammatory burden and disease severity. Serial bedside muscle US enables dynamic assessment of muscle status and may support clinical evaluation of metabolic and nutritional status in this high-risk population.

Disclosure of Interest: None declared