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Timed Stair-Climbing as a Surrogate Marker for Sarcopenia Measurements in Predicting Surgical Outcomes

  • Samantha Baker
  • Mary Glen Waldrop
  • Joshua Swords
  • Thomas Wang
  • Martin Heslin
  • Carlo Contreras
  • Sushanth Reddy
Original Article
  • 16 Downloads

Abstract

Background

Estimating sarcopenia by measuring psoas muscle density (PMD) has been advocated as a method to accurately predict post-operative morbidity. The aim of the present study was to determine whether the Timed Stair Climb (TSC) could be used to replace PMD measurements in predicting morbidity.

Methods

Patients were prospectively enrolled from March 2014–2015 and were eligible if they were undergoing an abdominal operation. PMD was measured using pre-operative CT scans obtained within 90 days of surgery. Ninety-day complications were assessed using the Accordion Severity Grading System. Multivariable analysis was performed to identify risk factors associated with operative morbidity.

Results

Of the patients, 298 were enrolled and completed TSC prior to undergoing an operation. Using the According Grading System, a grade 2 or higher complication occurred in 72 (24. 2%) patients with 8 (2.7%) deaths. There was an indirect relationship between PMD and TSC (P < 0.0001) and a direct relationship between TSC and complications (P = 0.04). On multivariable analysis decreasing PMD (P = 0.018) and increasing TSC (P = 0.026) were predictive of post-operative morbidity. Receiver operating characteristic curves demonstrated that the TSC was superior to both the ACS NSQIP Risk Calculator and PMD in predicting outcomes (TSC vs. PMD, P = 0.012; PMD vs. ACS NSQIP, P = 0.013; TSC vs. ACS NSQIP, P < 0.0001).

Conclusion

TSC, PMD, and the ACS NSQIP calculator are all useful tools; however, the TSC is superior in predicting post-operative morbidity.

Keywords

Sarcopenia Functional outcome Abdominal surgery Surgical risk 

Notes

Compliance with Ethical Standards

All authors have contributed substantially to the conception, design, acquisition, analysis, or interpretation of the data. In addition, all authors have participated in the critical revision and approval of the final manuscript.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  1. 1.Division of Surgical OncologyUniversity of Alabama at BirminghamBirminghamUSA

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