Evaluation of nutritional status using preoperative psoas muscle index and serum parameters in patients undergoing emergency laparotomy and investigation of its effects on postoperative mortality/morbidity

Aim: Emergency laparotomies are procedures associated with high mortality and morbidity rates. Sarcopenia has been linked to a poor prognosis in surgical patients. In this study, we aim to assess the nutritional status of patients undergoing emergency laparotomy by utilizing preoperative abdominal tomography and serum parameters. Additionally, we investigate the impact of these factors on postoperative mortality and morbidity. Material And Methods: Patients who underwent emergency laparotomy for non-traumatic reasons at the Department of General Surgery, Cerrahpaşa Medical Faculty, between 2022 and 2023 were included in the study. Sarcopenia was assessed by measuring the Skeletal Muscle Index and Psoas Muscle Index from preoperative abdominal tomography scans. The Prognostic Nutritional Index was calculated from preoperative blood tests. Patients were monitored throughout the study, and morbidity and mortality events were recorded. Results: Correlation analysis revealed significant associations between low Skeletal Muscle Index and mortality (OR=2,794, p=0,0023) and postoperative sepsis (OR=4,790, p=0,008); low Psoas Muscle Index and mortality (OR=3,661, p=0,004), postoperative sepsis (OR=8,593, p=0,001), reoperation (OR=4,011, p=0,0016), and renal failure (OR=3,677, p=0,037); and low Prognostic Nutritional Index and mortality (OR=5,502, p<0,0001), postoperative sepsis (OR=3,401, p=0,038), surgical site infection (OR=3,309, p=0,039), and reoperation (OR=3,971, p=0,008). Conclusion: Evaluating preoperative sarcopenia and nutritional status is crucial in predicting postoperative frailty in emergency laparotomy patients. Our findings highlight the need for a more practical preoperative frailty risk prediction model. Keywords: Skeletal Muscle Index, Psoas Muscle Index, Prognostic Nutritional Index, Morbidity, Mortality