Impact of sarcopenic obesity on 30-day mortality in critically ill patients with intra-abdominal sepsis

Purpose: This study aimed to investigate the association between sarcopenic obesity and 30-day mortality in critically ill patients with intra-abdominal sepsis. Material and methods: We analyzed 236 surgical ICU patients with sepsis due to intra-abdominal infection who underwent urgent surgical intervention. Sarcopenia, visceral obesity and sarcopenic obesity were analyzed by computed tomography scans using the third lumbar vertebrae skeletal muscle index and visceral adipose tissue area, using previously reported cutoff values. Results: The cohort was divided into 4 groups: 52 were diagnosed with sarcopenic obesity, 62 with sarcopenia only, 58 with visceral obesity only, and 64 with no sarcopenia or visceral obesity. 57 (24.2%) patients died within 30 days. The frequency of 30-day mortality differed significantly among the groups. Multivariate analysis showed that only sarcopenic obesity was associated with increased risk for 30-day mortality. Sarcopenic patients were older than non-sarcopenic patients. To address this limitation, subgroup analyses stratified by age showed that the risk of 30-day mortality increased significantly in sarcopenic patients, both in patients with age <= 70 years and in those with age > 70 years. Conclusion: Sarcopenic obesity is an independent risk factor for 30-day mortality in critically ill patients with intra-abdominal sepsis. (c) 2018 Elsevier Inc. All rights reserved.