Clinical Endoscopy

Influence of sarcopenia on clinical outcomes in peptic ulcer bleeding: a retrospective single-center analysis in Korea: Ji Hoon Yu, Hyun Tak Lee, Seok Ki Jang, Ah Young Lee, Jun-young Seo; Received July 30, 2024 Accepted October 13, 2024 Published online January 21, 2025; DOI: https://doi.org/10.5946/ce.2024.209 [Epub ahead of print]

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Peptic ulcer bleeding (PUB) is a major cause of nonvariceal gastrointestinal bleeding. As the older population increases, the prevalence of sarcopenia is also growing. Although sarcopenia influences the prognosis of various diseases, its association with clinical outcomes of PUB remains unknown. Therefore, this study aimed to explore this correlation.
Methods
We retrospectively analyzed 2,050 patients who underwent esophagogastroduodenoscopy for suspected gastrointestinal bleeding between January 2014 and December 2021. Patients who underwent computed tomography scans were included for sarcopenia evaluation based on the psoas muscle index, defined as the total psoas area normalized by the square of the height of the patient. Sarcopenia was defined using specific cutoffs: ≤7.3 cm2/m2 and ≤5.1 cm2/m2 for men and women, respectively. The primary outcome measured was the 30-day mortality rate.
Results
Out of 358 patients, 149 were diagnosed with sarcopenia. The 30-day mortality rate was significantly higher in patients with sarcopenia than in those without. Multivariate regression analysis revealed significant associations between sarcopenia, a high age, blood tests, and comorbidity score, and administration of inotropic agents with 30-day mortality.
Conclusions
Our study showed that the presence of sarcopenia, elevated comorbidity scores, and use of inotropes were associated with higher 30-day mortality rates. Considering that sarcopenia may influence the clinical outcomes in patients with PUB, it is crucial to manage patients with sarcopenia with particular care.

333 View
70 Download

Clinical meaning of sarcopenia in patients undergoing endoscopic treatment: Hiroyuki Hisada, Yosuke Tsuji, Hikaru Kuribara, Ryohei Miyata, Kaori Oshio, Satoru Mizutani, Hideki Nakagawa, Rina Cho, Nobuyuki Sakuma, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Seiichi Yakabi, Yu Takahashi, Yoshiki Sakaguchi, Naomi Kakushima, Nobutake Yamamichi, Mitsuhiro Fujishiro; Clin Endosc 2024;57(4):446-453. Published online March 22, 2024; DOI: https://doi.org/10.5946/ce.2023.193

With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.

Citations

Citations to this article as recorded by

Clinical Significance of Sarcopenia in Elderly Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis
Yuanhao Su, Yongke Wu, Cheng Li, Yiyuan Zhao, Yunhao Li, Xing Jin, Zhidong Wang
Digestive Diseases and Sciences.2024; 69(8): 2970. CrossRef

4,218 View
237 Download
1 Web of Science
1 Crossref

Impact of sarcopenia on biliary drainage during neoadjuvant therapy for pancreatic cancer: Kunio Kataoka, Eizaburo Ohno, Takuya Ishikawa, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Hideki Takami, Osamu Maeda, Junpei Yamaguchi, Yukihiro Yokoyama, Tomoki Ebata, Yasuhiro Kodera, Hiroki Kawashima; Clin Endosc 2024;57(1):112-121. Published online July 18, 2023; DOI: https://doi.org/10.5946/ce.2022.278

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Since the usefulness of neoadjuvant chemo(radiation) therapy (NAT) for pancreatic cancer has been demonstrated, recurrent biliary obstruction (RBO) in patients with pancreatic cancer with a fully covered self-expandable metal stent (FCSEMS) during NAT is expected to increase. This study investigated the impact of sarcopenia on RBO in this setting.
Methods
Patients were divided into normal and low skeletal muscle index (SMI) groups and retrospectively analyzed. Patient characteristics, overall survival, time to RBO (TRBO), stent-related adverse events, and postoperative complications were compared between the two groups. A Cox proportional hazard model was used to identify the risk factors for short TRBO.
Results
A few significant differences were observed in patient characteristics, overall survival, stent-related adverse events, and postoperative complications between 38 patients in the normal SMI group and 17 in the low SMI group. The median TRBO was not reached in the normal SMI group and was 112 days in the low SMI group (p=0.004). In multivariate analysis, low SMI was the only risk factor for short TRBO, with a hazard ratio of 5.707 (95% confidence interval, 1.148–28.381; p=0.033).
Conclusions
Sarcopenia was identified as an independent risk factor for RBO in patients with pancreatic cancer with FCSEMS during NAT.

Citations

Citations to this article as recorded by

Endeavors to prevent stent malfunction: new insights into the risk factors for recurrent biliary obstruction
Sung-Jo Bang
Clinical Endoscopy.2024; 57(1): 56. CrossRef
Skeletal muscle status and survival among patients with advanced biliary tract cancer
Shinya Takaoka, Tsuyoshi Hamada, Naminatsu Takahara, Kei Saito, Go Endo, Ryunosuke Hakuta, Kota Ishida, Kazunaga Ishigaki, Sachiko Kanai, Kohei Kurihara, Hiroki Oyama, Tomotaka Saito, Tatsuya Sato, Tatsunori Suzuki, Yukari Suzuki, Shuichi Tange, Yurie Tok
International Journal of Clinical Oncology.2024; 29(3): 297. CrossRef

3,215 View
150 Download
2 Web of Science
2 Crossref

Search