2130. Impact of Sarcopenic Obesity on Surgical Site Infection after Gastric Cancer Surgery: a Retrospective Study of 1038 Patients
Session: Poster Abstract Session: Healthcare Epidemiology: Surgical Site Infections
Saturday, October 6, 2018
Room: S Poster Hall
Background:

Recent studies have shown that body composition is an important factor affecting surgical outcomes. In this study, we investigate the effect of sarcopenic obesity on surgical site infection (SSI) after gastric cancer surgery.

Methods:

We performed a retrospective cohort study of 1038 patients who underwent gastric cancer surgery between January 2015 and December 2015 at tertiary care hospital in Seoul, Korea. Visceral fat area (VFA) and total abdominal muscle area (TAMA) were assessed at preoperative staging computed tomography scan. Sarcopenic obesity was defined as high VFA/TAMA ratio and receiver operating characteristic (ROC) curves were used to determine the threshold of VFA/TAMA ratio to predict SSI after gastric cancer surgery. Multivariate logistic regression analysis was used to identify independent risk factors for SSI.

Results:

Of the 1038 eligible patients, 58 patients (5.6%) developed SSI. The average value of VFA/TAMA is 2.69 ± 1.43 in non-SSI group and 3.38 ± 1.34 in SSI group (P < 0.001). By using ROC curve, the cut-off value of VFA/TAMA to predict SSI is 3 (AUC 0.653; sensitivity 67%, specificity 61%). Multivariate analysis indicated that smoking (odds ratio (OR), 1.99; 95% confidence interval (CI), 1.1–3.62; P = 0.024), total gastrectomy (OR, 2.45; 95% CI, 1.36–4.42; P = 0.003), stage III, IV cancer (OR, 2.58; 95% CI, 1.44–4.63; P = 0.001) and sarcopenic obesity (OR, 2.85; 95% CI, 1.6–5.06; P < 0.001) were independent risk factors for SSI after gastric cancer surgery. In sarcopenic obesity patients, the incidence rate of Clavien-Dindo score IIIa or higher postoperative complication (7.1% vs. 4%; P = 0.028), mean days of postoperative hospital stay (8.42 ± 7.93 vs. 7.12 ± 3.54; P < 0.001), and the incidence rate of delayed complications requiring re-admission within 30 days (6.1% vs. 2.7%; P = 0.007) were statistically significantly higher than those of the non sarcopenic obesity patients.

Conclusion:

Sarcopenic obesity is an independent risk factor for the development of SSI after gastric cancer surgery. In addition, sarcopenic obesity is associated with high incidence of postoperative complication, prolongation of postoperative hospital stay and an increase of re-admission rate within 30 days.

Jung Ho Kim, MD1, Jinnam Kim, MD2, Woon Ji Lee, MD2, Hye Seong, MD3, Heun Choi, MD1, Je Eun Song, M.D.4, Eun Jin Kim, M.D.5, Jin Young Ahn, MD1, Su Jin Jeong, MD/PhD6, Nam Su Ku, MD, PhD6, Taeil Son, M.D.2, Hyoung-Il Kim, MD2, Sang Hoon Han, MD, PhD7, Jun Yong Choi, MD, PhD6, Joon Sup Yeom, MD, PhD6, Woo Jin Hyung, MD2, Young Goo Song, MD, PhD7, Sung Hoon Noh, MD2 and June Myung Kim, MD, PhD6, (1)Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South), (2)Yonsei University College of Medicine, Seoul, Korea, Republic of (South), (3)Dpartment of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South), (4)Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea, Republic of (South), (5)Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Korea, Republic of (South), (6)Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea, Republic of (South), (7)Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South)

Disclosures:

J. H. Kim, None

J. Kim, None

W. J. Lee, None

H. Seong, None

H. Choi, None

J. E. Song, None

E. J. Kim, None

J. Y. Ahn, None

S. J. Jeong, None

N. S. Ku, None

T. Son, None

H. I. Kim, None

S. H. Han, None

J. Y. Choi, None

J. S. Yeom, None

W. J. Hyung, None

Y. G. Song, None

S. H. Noh, None

J. M. Kim, None

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