Surgical Outcomes Best Predicted by Timed-Stair Climb when Compared to Sarcopenia Measurements

Objective: Estimating sarcopenia by measuring psoas muscle density (PMD) has been advocated as a method to accurately predict post-operative morbidity. The aim of the present study was to determine whether the TSC could be... [ view full abstract ]

Objective: Estimating sarcopenia by measuring psoas muscle density (PMD) has been advocated as a method to accurately predict post-operative morbidity. The aim of the present study was to determine whether the TSC could be used to replace PMD measurements in predicting morbidity.

 Methods: From March 2014-2015, 298 patients attempted TSC prior to undergoing surgery. PMD was measured using pre-operative CT scans obtained within 90 days of surgery. Ninety-day complications were assessed using the Accordion Severity Grading System. Multivariable analysis was performed to identify risk factors associated with operative morbidity.

 Results: A grade 2 or higher complication occurred in 72 (24. 2%) patients with 8 (2. 7%) deaths. There was an indirect relationship between PMD and TSC (P<0. 0001) and a direct relationship between TSC and complications (P=0.04). On multivariable analysis decreasing PMD (P=0.018) and increasing TSC (P=0.026) were predictive of post-operative morbidity. Receiver operating characteristic curves demonstrated that the TSC was superior to both the ACS NSQIP Risk Calculator and PMD in predicting outcomes (TSC vs. PMD, P=0.012, PMD vs. ACS NSQIP, P=0.013, TSC vs. ACS NSQIP, P< 0.0001).

Conclusion: TSC, PMD, and the ACS NSQIP calculator are all useful tools; however the TSC is superior in predicting post-operative morbidity.