Sarcopenia increases the risk of early biliary infection after percutaneous transhepatic biliary stent placement

Qi Chen; Xun Lu; Zhong-Kai Wang; Cheng Feng; Xi-Juan Yao; Jin-He Guo

doi:10.3389/fonc.2022.1039987

Sarcopenia increases the risk of early biliary infection after percutaneous transhepatic biliary stent placement

Front Oncol. 2022 Dec 9:12:1039987. doi: 10.3389/fonc.2022.1039987. eCollection 2022.

Authors

Qi Chen¹, Xun Lu^{2

3}, Zhong-Kai Wang¹, Cheng Feng¹, Xi-Juan Yao¹, Jin-He Guo¹

Affiliations

¹ Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
² Department of Urology, Affiliated Zhongda hospital of Southeast University, Nanjing, China.
³ Surgical Research Center, Institute of Urology, School of Medicine, Southeast University, Nanjing, China.

Abstract

Purpose: To assess the association between sarcopenia and the risk of early biliary infection (EBI) after percutaneous transhepatic biliary stent (PTBS) placement in patients with inoperable biliary tract cancer (BTC).

Patients and methods: In this single center, retrospective observational study, patients diagnosed with inoperable BTC undergoing PTBS placement between January 2013 and July 2021 were enrolled. Preoperative sarcopenia was defined based on skeletal muscle mass measured by computed tomography images on the level of third lumbar vertebra within one month before PTBS placement. Patients were divided into two groups in accordance with the status of sarcopenia. Univariate and further multivariate logistic analyses were performed to determine predictors for EBI. Stratified and interactive analyses were conducted to investigate the stability of results. Further receiver operating characteristic curve was performed to determine the predictive value of sarcopenia on EBI after PTBS placement.

Results: Totally, 134 patients were included in this retrospective study, with 45 (33.6%) patients characterized as sarcopenia. The incidence rate of EBI was 26.9% (36/134). Multivariate analyses demonstrated that sarcopenia [Odds ratio (OR), 2.75; 95%CI: 1.11-6.77; P=0.028], obstruction length (OR, 1.04; 95%CI: 1.00-1.08; P=0.030) and diabetes (OR, 2.46; 95%CI: 1.01-5.96; P=0.047) were significant predictors of EBI. There were no significant interactions in different subgroups (P for interaction > 0.05). Moreover, the areas under the curves (AUC) revealed that the combined index containing sarcopenia, obstruction length, and diabetes showed the better predictive value (AUC= 0.723) than either one alone.

Conclusion: Sarcopenia increased the risk of EBI in patients with inoperable BTC after PTBS placement. Preoperative assessment of sarcopenia may aid in risk stratification. Patients with sarcopenia should be given intensive monitoring.

Keywords: biliary tract cancer; early biliary infection; microbiology; percutaneous transhepatic biliary stent; sarcopenia.