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Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy
(1) Background: Percutaneous endoscopic gastrostomy (PEG) is a widely used long-term enteral nutrition method, but little is known about the associated prognostic factors in patients with PEG. Sarcopenia, a condition characterized by a loss of skeletal muscle mass, increases the risk of developing v...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218806/ https://www.ncbi.nlm.nih.gov/pubmed/37240466 http://dx.doi.org/10.3390/jcm12103360 |
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author | Ono, Shingo Furuhashi, Hiroto Kisaki, Shunsuke Horiuchi, Hideka Matsui, Hiroaki Dobashi, Akira Ojiri, Hiroya Sumiyama, Kazuki |
author_facet | Ono, Shingo Furuhashi, Hiroto Kisaki, Shunsuke Horiuchi, Hideka Matsui, Hiroaki Dobashi, Akira Ojiri, Hiroya Sumiyama, Kazuki |
author_sort | Ono, Shingo |
collection | PubMed |
description | (1) Background: Percutaneous endoscopic gastrostomy (PEG) is a widely used long-term enteral nutrition method, but little is known about the associated prognostic factors in patients with PEG. Sarcopenia, a condition characterized by a loss of skeletal muscle mass, increases the risk of developing various gastrointestinal disorders. Yet, the relationship between sarcopenia and the prognosis after PEG remains unclear. (2) Methods: We conducted a retrospective study of patients who underwent PEG consecutively from March 2008 to April 2020. We analyzed preoperative sarcopenia and the prognosis of patients after PEG. We defined sarcopenia as a skeletal muscle index at the level of the third lumbar vertebra of ≤29.6 cm(2)/m(2) for women and ≤36.2 cm(2)/m(2) for men. Cross-sectional computed tomography images of skeletal muscle at the level of the third lumbar vertebra were evaluated using DICOM image analysis software (OsiriX). The primary outcome was the difference in overall survival after PEG based on the status of sarcopenia. We also performed a covariate balancing propensity score matching analysis. (3) Results: Of 127 patients (99 men, 28 women), 71 (56%) were diagnosed with sarcopenia, and 64 patients died during the observation period. The median follow-up period did not differ between patients with and without sarcopenia (p = 0.5). The median survival time after PEG was 273 days in patients with sarcopenia and 1133 days in those without (p < 0.001). Cox proportional hazard model analyses identified three factors that were significantly associated with overall survival: sarcopenia (adjusted hazard ratio [HR]: 2.9, 95% confidence interval [CI]: 1.6–5.4, p < 0.001), serum albumin level (adjusted HR: 0.34, 95% CI: 0.21–0.55, p < 0.001) and male sex (adjusted HR: 2.0, 95% CI: 1.1–3.7, p = 0.03). Propensity score-matched analysis (n = 37 vs. 37) showed that the survival rate was lower in the sarcopenia group than in the non-sarcopenia group (at 90 days: 77% (95% CI, 59–88) vs. 92% (76–97), at 180 days: 56% (38–71) vs. 92% (76–97), and at one year: 35% (19–51) vs. 81% (63–91), p = 0.0014). (4) Conclusions: Sarcopenia was associated with poor prognosis in patients having undergone PEG. |
format | Online Article Text |
id | pubmed-10218806 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102188062023-05-27 Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy Ono, Shingo Furuhashi, Hiroto Kisaki, Shunsuke Horiuchi, Hideka Matsui, Hiroaki Dobashi, Akira Ojiri, Hiroya Sumiyama, Kazuki J Clin Med Article (1) Background: Percutaneous endoscopic gastrostomy (PEG) is a widely used long-term enteral nutrition method, but little is known about the associated prognostic factors in patients with PEG. Sarcopenia, a condition characterized by a loss of skeletal muscle mass, increases the risk of developing various gastrointestinal disorders. Yet, the relationship between sarcopenia and the prognosis after PEG remains unclear. (2) Methods: We conducted a retrospective study of patients who underwent PEG consecutively from March 2008 to April 2020. We analyzed preoperative sarcopenia and the prognosis of patients after PEG. We defined sarcopenia as a skeletal muscle index at the level of the third lumbar vertebra of ≤29.6 cm(2)/m(2) for women and ≤36.2 cm(2)/m(2) for men. Cross-sectional computed tomography images of skeletal muscle at the level of the third lumbar vertebra were evaluated using DICOM image analysis software (OsiriX). The primary outcome was the difference in overall survival after PEG based on the status of sarcopenia. We also performed a covariate balancing propensity score matching analysis. (3) Results: Of 127 patients (99 men, 28 women), 71 (56%) were diagnosed with sarcopenia, and 64 patients died during the observation period. The median follow-up period did not differ between patients with and without sarcopenia (p = 0.5). The median survival time after PEG was 273 days in patients with sarcopenia and 1133 days in those without (p < 0.001). Cox proportional hazard model analyses identified three factors that were significantly associated with overall survival: sarcopenia (adjusted hazard ratio [HR]: 2.9, 95% confidence interval [CI]: 1.6–5.4, p < 0.001), serum albumin level (adjusted HR: 0.34, 95% CI: 0.21–0.55, p < 0.001) and male sex (adjusted HR: 2.0, 95% CI: 1.1–3.7, p = 0.03). Propensity score-matched analysis (n = 37 vs. 37) showed that the survival rate was lower in the sarcopenia group than in the non-sarcopenia group (at 90 days: 77% (95% CI, 59–88) vs. 92% (76–97), at 180 days: 56% (38–71) vs. 92% (76–97), and at one year: 35% (19–51) vs. 81% (63–91), p = 0.0014). (4) Conclusions: Sarcopenia was associated with poor prognosis in patients having undergone PEG. MDPI 2023-05-09 /pmc/articles/PMC10218806/ /pubmed/37240466 http://dx.doi.org/10.3390/jcm12103360 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ono, Shingo Furuhashi, Hiroto Kisaki, Shunsuke Horiuchi, Hideka Matsui, Hiroaki Dobashi, Akira Ojiri, Hiroya Sumiyama, Kazuki Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy |
title | Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy |
title_full | Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy |
title_fullStr | Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy |
title_full_unstemmed | Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy |
title_short | Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy |
title_sort | sarcopenia is a prognostic factor in patients undergoing percutaneous endoscopic gastrostomy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218806/ https://www.ncbi.nlm.nih.gov/pubmed/37240466 http://dx.doi.org/10.3390/jcm12103360 |
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