The association between preoperative body composition and aerobic fitness in patients scheduled for colorectal surgery.

Berkel AEM; van Dijk DPJ; Prins SN; van Meeteren NLU; Olde Damink SWM; Klaase JM; Bongers BC;

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
[Colorectal Dis] 2021 Oct 06. Date of Electronic Publication: 2021 Oct 06.

Aim: Though cardiopulmonary exercise testing (CPET) is considered the gold standard, the preoperative abdominal computed tomography (CT) scan might also provide information concerning preoperative aerobic fitness for risk assessment. This study aimed to investigate the association between preoperative CT-scan derived body composition variables and preoperative CPET variables of aerobic fitness in colorectal surgery.
Method: In this retrospective cohort study, CT-images at level L3 were analysed for skeletal muscle mass, skeletal muscle radiation attenuation, visceral adipose tissue (VAT) mass, and subcutaneous adipose tissue mass. Regression analyses were performed to investigate the relation between CT-scan derived body composition variables, CPET-derived aerobic fitness, and other preoperative patient-related variables. Logistic regression analysis was performed to predict a preoperative anaerobic threshold (AT) ≤11.1 mL/kg/min as cut-off for having a high risk for postoperative complications.
Results: Data from 78 patients (45 males, mean (SD) age 74.5 (6.4) years) were analysed. A correlation coefficient of 0.55 was observed between absolute AT and skeletal muscle mass index. Absolute AT (R 2 of 51.1%) was lower in patients with a lower skeletal muscle mass index, together with higher age, lower body mass, and higher American Society of Anesthesiologists (ASA) score. Higher ASA score (odds ratio 5.64; P=0.033) and higher VAT mass (odds ratio 1.02; P=0.036) were associated with an increased risk of an AT ≤11.1 mL/kg/min.
Conclusion: Body composition variables from the preoperative CT-scan were moderately associated with preoperative CPET-derived aerobic fitness. Higher ASA score and higher VAT mass were associated with an increased risk of an AT ≤11.1 mL/kg/min.