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2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients

BACKGROUND: Sarcopenia (reduced skeletal muscle mass) has been associated with serious infection in liver transplant recipients. We analyzed the association of sarcopenia and early post-surgical infections in kidney transplant recipients. METHODS: Retrospective cohort study of 125 patients underwent...

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Autores principales: Villacorta, Evelyn, Acosta, Luis, Myint, Thein, Leedy, Nicole, Lia Castellanos, Ana, Gedaly, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810160/
http://dx.doi.org/10.1093/ofid/ofz360.2339
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author Villacorta, Evelyn
Acosta, Luis
Myint, Thein
Leedy, Nicole
Lia Castellanos, Ana
Gedaly, Roberto
author_facet Villacorta, Evelyn
Acosta, Luis
Myint, Thein
Leedy, Nicole
Lia Castellanos, Ana
Gedaly, Roberto
author_sort Villacorta, Evelyn
collection PubMed
description BACKGROUND: Sarcopenia (reduced skeletal muscle mass) has been associated with serious infection in liver transplant recipients. We analyzed the association of sarcopenia and early post-surgical infections in kidney transplant recipients. METHODS: Retrospective cohort study of 125 patients underwent kidney transplantation from 2010 to 2014 at University of Kentucky Medical Center. Sarcopenia was diagnosed by measuring the skeletal muscle mass on computed tomography imaging obtained during the pre-transplant evaluation using SliceOmatic 5.0 software at L3 level (≤ 52.4 cm(2)/m(2) in males and ≤ 38.5 cm(2)/m(2) in females). Early post-transplant infections were confirmed by positive culture from blood, urine, and/or peritoneal fluid within 30 days after kidney transplantation. A generalized linear model (GLM) was used to identify variables predictive of post- surgical infection and Risk Ratio (RR) was obtained, with a P-value of < 0.05. The statistical analysis was performed with STATA version 12.0 (College Station, Texas). RESULTS: Among 125 patients, 52 (41.6%) were identified with sarcopenia, 110 (88.0%) patients were white, 76 (60.8%) male, with a median age of 56 (range 20–72) at the time of transplant. Diabetes was reported in 50 (40.0%) patients, obesity in 64 (51.6%) patients and smoking in 43 (34.6%) patients. Six (4.8%) patients had graft failure. Infections were identified in 22 (17.6%) patients, more than one source of infection was reported in 4 (3.2%) cases. The most common infections were urinary tract infection in 13 (10.4%) patients and bacteremia in 5 (4.0%) patients. The median time to development of infection was 9 days (range 1–27). In the bivariate analysis, sarcopenia was associated with high risk of post-surgical infections (RR 2.45; 95% CI 1.10–5.44). In multivariable analysis, sarcopenia was a significant independent predictor of infection (RR 2.58; 95% CI 1.20–5.52). None associations were found with other variables; age over 40 years, male sex, smoking, obesity and diabetes. CONCLUSION: Our study suggested that sarcopenia was associated with an increased risk of early post-surgical infection in kidney transplant recipients. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68101602019-10-28 2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients Villacorta, Evelyn Acosta, Luis Myint, Thein Leedy, Nicole Lia Castellanos, Ana Gedaly, Roberto Open Forum Infect Dis Abstracts BACKGROUND: Sarcopenia (reduced skeletal muscle mass) has been associated with serious infection in liver transplant recipients. We analyzed the association of sarcopenia and early post-surgical infections in kidney transplant recipients. METHODS: Retrospective cohort study of 125 patients underwent kidney transplantation from 2010 to 2014 at University of Kentucky Medical Center. Sarcopenia was diagnosed by measuring the skeletal muscle mass on computed tomography imaging obtained during the pre-transplant evaluation using SliceOmatic 5.0 software at L3 level (≤ 52.4 cm(2)/m(2) in males and ≤ 38.5 cm(2)/m(2) in females). Early post-transplant infections were confirmed by positive culture from blood, urine, and/or peritoneal fluid within 30 days after kidney transplantation. A generalized linear model (GLM) was used to identify variables predictive of post- surgical infection and Risk Ratio (RR) was obtained, with a P-value of < 0.05. The statistical analysis was performed with STATA version 12.0 (College Station, Texas). RESULTS: Among 125 patients, 52 (41.6%) were identified with sarcopenia, 110 (88.0%) patients were white, 76 (60.8%) male, with a median age of 56 (range 20–72) at the time of transplant. Diabetes was reported in 50 (40.0%) patients, obesity in 64 (51.6%) patients and smoking in 43 (34.6%) patients. Six (4.8%) patients had graft failure. Infections were identified in 22 (17.6%) patients, more than one source of infection was reported in 4 (3.2%) cases. The most common infections were urinary tract infection in 13 (10.4%) patients and bacteremia in 5 (4.0%) patients. The median time to development of infection was 9 days (range 1–27). In the bivariate analysis, sarcopenia was associated with high risk of post-surgical infections (RR 2.45; 95% CI 1.10–5.44). In multivariable analysis, sarcopenia was a significant independent predictor of infection (RR 2.58; 95% CI 1.20–5.52). None associations were found with other variables; age over 40 years, male sex, smoking, obesity and diabetes. CONCLUSION: Our study suggested that sarcopenia was associated with an increased risk of early post-surgical infection in kidney transplant recipients. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810160/ http://dx.doi.org/10.1093/ofid/ofz360.2339 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Villacorta, Evelyn
Acosta, Luis
Myint, Thein
Leedy, Nicole
Lia Castellanos, Ana
Gedaly, Roberto
2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients
title 2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients
title_full 2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients
title_fullStr 2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients
title_full_unstemmed 2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients
title_short 2661. Sarcopenia Increases Risk of Post-Surgical Infections in Kidney Transplant Recipients
title_sort 2661. sarcopenia increases risk of post-surgical infections in kidney transplant recipients
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810160/
http://dx.doi.org/10.1093/ofid/ofz360.2339
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