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Effectiveness of sarcopenia measured by dynamometry as a predictor of colonic anastomotic leakage
Effectiveness of sarcopenia measured by dynamometry as a predictor of colonic anastomotic leakage
Ángel A. García-León 1 
, Mateo Ponciano-Guerrero 2 , Álvaro J. Montiel-Jarquín 3 , José A. Parra-Salazar 4 , Irán Moreno-Martínez 5 , Arturo García-Galicia 1 , Nancy R. Bertado-Ramírez 3 , Angélica Porras-Juárez 3 , Jorge Loría-Castellanos 6 , Sandra Maldonado-Castañeda 7
1 Dirección de Educación e Investigación en Salud, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social (IMSS) Puebla, México; 2 Departamento de Gastrocirugía, Hospital de Especialidades Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Puebla, Pue., México; 3 Dirección de Educación e Investigación enSalud, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 4 Dirección General, Hospital de Especialidades Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Puebla, Pue., México; 5 Departamento de Cirugía General, Hospital de Especialidades Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho. Puebla, Pue., México; 6 Red Nacional de Educadores en Simulación Clínica, Ciudad de México. México; 7 Modelo de Atención a la Salud para el Bienestar, IMSS Bienestar, Puebla, Pue., México
*Correspondence: Álvaro J. Montiel-Jarquín. Email: dralmoja@hotmail.com
Abstract
Background: Sarcopenia reflects poor nutritional status in patients and a risk factor for colorectal anastomotic leaks. Computed tomography is the most widely used method for assessing sarcopenia; however, a simple, inexpensive, and accessible method, such as handheld dynamometry, is needed that can be applied before surgery.
Objective: To establish the usefulness of the diagnosis of sarcopenia measured by dynamometry as a predictor of colonic anastomosis leakage.
Material and methods: The study is transversal, experimental. Brachial strength was measured with hand dynamometry. Spearman’s rho and area under the ROC curve were used.
Results: There is a correlation between sarcopenia measured by dynamometry and anastomotic leakage (p = 0.011), with a sensitivity of 66% and specificity of 90% for dynamometry in parameters less than 25.3 pounds, area under the ROC curve. Leakage is more frequent in men, and smoking has no association with anastomotic leakage. Comorbidities are related to leakage. The height of the anastomosis does influence the leakage, inferring that the higher it is, the greater the risk of leakage. Despite that patients who were prehabilitated did not present leakage in the anastomosis, no protective association was found between prehabilitation and anastomotic leakage.
Conclusions: There is a relationship between sarcopenia measured by dynamometry and anastomotic leakage; however, no protective association was found.
Keywords: Anastomosis. Sarcopenia. Dynamometer. Dehiscence. Colon.
