Effect of Sarcopenia on Pneumonia after Endoscopic Submucosal Resection in Patients Aged ≥65 Years: A Retrospective Study

Abstract

We aimed to investigate the association between sarcopenia and incidence of pneumonia after endoscopic submucosal dissection (ESD) in patients aged ≥65 years. Patients with (n = 1571) and without sarcopenia (n = 1718) who underwent ESD for gastric neoplasm were included. Propensity score matching (PSM) was performed between the groups (n = 785) at a 1:1 ratio. The primary endpoint was the effect of sarcopenia on the incidence of pneumonia after ESD. Among the included patients, 2.2% (n = 71) developed pneumonia after ESD. After PSM, the incidence rate of pneumonia was significantly higher in patients with sarcopenia than that in patients without sarcopenia (p = 0.024). Sarcopenia and age ≥73 years were significantly associated with the incidence of pneumonia (sarcopenia and age <73 years, odd ratio (OR) = 1.22 [95% confidence interval (CI): 0.46–3.22]; sarcopenia and age ≥73 years, OR = 3.92 [95% CI: 1.79–8.74]). Patients with sarcopenia had an increased risk of developing pneumonia after ESD, even after adjusting for other factors, resulting in a higher incidence of leukocytosis and a longer duration of post-ESD hospitalization. The combination of sarcopenia and age ≥73 years could be an effective predictive factor for screening high-risk groups for pneumonia after ESD.

Keywords

• endoscopic submucosal dissection
• pneumonia
• sarcopenia
• old age
• sedation
• hospital stay