Influence of sarcopenia on clinical outcomes in peptic ulcer bleeding: a retrospective single-center analysis in Korea
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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 associationwith 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 gastrointestinalbleeding between January 2014 and December 2021. Patients who underwent computed tomography scans were included for sarcopeniaevaluation 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 outcomemeasured 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 withsarcopenia 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 associatedwith higher 30-day mortality rates. Considering that sarcopenia may influence the clinical outcomes in patients with PUB, it is crucialto manage patients with sarcopenia with particular care.
Abstract
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 associationwith 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 gastrointestinalbleeding between January 2014 and December 2021. Patients who underwent computed tomography scans were included for sarcopeniaevaluation 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 outcomemeasured 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 withsarcopenia 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 associatedwith higher 30-day mortality rates. Considering that sarcopenia may influence the clinical outcomes in patients with PUB, it is crucialto manage patients with sarcopenia with particular care.