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Incidence of Sarcopenia in Patients Undergoing Autologous Breast Reconstruction with Free Tissue Transfer
Eric Pittelkow, MD
Will Debrock, BS
Briana McLaughlin, BS
Alladin Hassanein, MD
Juan Socas, MD
Mary Lester, MD
Steve Duquette, MD
Indiana University School of Medicine, Division of Plastic and Reconstructive Surgery
2018-01-27
Presenter: Will DeBrock
Affidavit:
The residents writing this abstract are responsible for 100% of the original work.
Director Name: William Wooden
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction:
Sarcopenia is a condition characterized by the loss of skeletal muscle mass and function. This condition has been proven to be a risk factor for postoperative complications in thoracic, transplant, and abdominal surgery patients. Sarcopenia incidence has been shown to be as high as 10%. Sarcopenia has not been assessed in plastic surgery patients. The purpose of this study was evaluate the incidence of sarcopenia in patients undergoing autologous breast reconstruction.
Methods:
Patients that underwent autologous breast reconstruction following mastectomy from 2013 to 2016 were evaluated. The cross-sectional area (CSA) of skeletal muscle was measured from preoperative CT scans at L3 using the NIH ImageJ software. CSA was normalized to patient height (cm2/m2). A previously published skeletal muscle index (SMI) of 38.5 cm2/m2 was used to define sarcopenia.
Results:
Eight of the 103 (7.8%) patients were found to have sarcopenia. The majority of both sarcopenic and non-sacropenic patients underwent reconstruction with deep inferior epigastric perforator flaps (75%, and 95.8%, respectively). Average age in sarcopenic and non-sarcopenic patients was 47.4 and 48.9 years, respectively. Patients with sarcopenia had significantly lower BMI (24.09 kg/m2 vs. 31.19 kg/m2, p=.002), and SMI (35.95 cm2/m2 vs 50.48 cm2/m2, p<.0005). There was no statistically significant difference in age, smoking, diabetes, cardiac disease, lymph node dissection, and adjuvant/neoadjuvant therapy.
Conclusion:
Sarcopenia was identified in 7.8% of patients and can be found using standard pre-operative CT scans and available software. Further investigation is needed to evaluate the effect of sarcopenia on surgical outcomes after breast reconstruction.
