OBJECTIVES:Patients in regional and rural areas consistently experience poorer lung cancer survival rates compared with those in metropolitan centres, but the reasons remain unclear. This study examined survival differences in non-small cell lung cancer (NSCLC) across Victoria and identified key prognostic factors contributing to these differences. DESIGN:Retrospective cohort study. SETTING AND PARTICIPANTS:NSCLC patients diagnosed between 1 July 2011 and 22 May 2023 identified from the Victorian Lung Cancer Registry (VLCR). MAIN OUTCOME MEASURES:Residential address and treatment institution were classified using the Modified Monash Model (MMM): Modified Monash (MM) category 1 (MM1) as metropolitan, MM2 as regional and MM3-MM7 as rural/remote. Demographic, socio-economic and cancer-specific factors were analysed as potential predictors of all-cause mortality. RESULTS:Among 13,548 patients, 4244 (31%) lived in regional or rural/remote areas. Compared with metropolitan patients, these groups had higher smoking prevalence (metropolitan, 2848/9304 [31%] vs. regional, 366/1083 [34%] vs. rural, 1148/3161 [37%]) and were more likely to be Australian-born (metropolitan, 4919/9304 [53%] vs. regional, 873/1083 [81%] vs. rural, 2603/3161 [82%]; p < 0.001). Comorbidity burden was similar across groups (median, 1; interquartile range, 0.0-1.0; p = 0.19). Socio-economic disadvantage was more marked in regional and rural patients (median Index of Relative Socio-Economic Advantage and Disadvantage [IRSAD] deciles: metropolitan, 8.0 vs. regional, 5.0 vs. rural, 3.0; p < 0.001), and average travel times to treatment were longer (metropolitan, 0.4 vs. regional, 1.9 vs. rural, 2.8 h, respectively). Patients treated at regional institutions had poorer survival (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.19-1.35; p < 0.001). This difference persisted after adjustment for age, stage, performance status, smoking and comorbidities (HR, 1.11; 95% CI, 1.04-1.18; p = 0.001). CONCLUSIONS:Regional, rural and remote patients with NSCLC face greater socio-economic disadvantage and travel burdens, and experience poorer survival even after accounting for clinical and demographic factors. These findings highlight enduring inequities in lung cancer care and emphasise the need for targeted interventions to strengthen access, treatment equity and outcomes for non-metropolitan populations.

Introduction A key dogma in the management of extensive-stage small cell lung cancer (ES-SCLC) is rapid diagnosis and treatment. However, the impact of treatment timeliness in a real-world setting is incompletely understood. Methods Patients with ES-SCLC were identified from the Victorian Lung Cancer Registry (VLCR). Referral-to-diagnosis, referral-to-treatment and diagnosis-to-treatment intervals were calculated and defined as timely if they were less than 28 days, 42 days and 14 days, respectively. The impact of timeliness on overall survival was determined using univariable and multivariable Cox proportional hazards regression. Results From January 2012 to April 2023, the VLCR enrolled 1,195 patients with ES-SCLC, including 995 who were treated with chemotherapy. The median referral-to-diagnosis, referral-to-treatment and diagnosis-to-treatment intervals were 8 days (IQR 4-17 days), 18 days (IQR 10-31 days) and 7 days (IQR 4-13 days), respectively. Mortality risk was greater with a shorter diagnosis-to-treatment time (hazard ratio (HR), 1.31 for <14 days versus ≥14 days; 95% confidence interval (CI): 1.12-1.54; p=0.001), which was corroborated by multivariable regression (adjusted HR, 1.32; 95% CI: 1.13-1.56; p=0.001). Poorer survival was also observed with a shorter referral-to-diagnosis interval (adjusted HR, 1.37 for <28 days versus ≥28 days; 95% CI: 1.10-1.71; p=0.005) and shorter referral-to-treatment interval (adjusted HR, 1.58 for <42 days versus ≥42 days; 95% CI: 1.28-1.95; p<0.0001). Conclusion The majority of patients captured in the VLCR received timely care. Although earlier treatment predicted worse overall survival, the effects of timely care on symptom control and quality of life remain important considerations that require further characterization.

BACKGROUND:Patients receiving extracorporeal membrane oxygenation (ECMO) are considered nutritionally vulnerable, with previous studies focussed on Intensive Care Unit (ICU) admission alone. We aimed to address this gap by describing nutrition provision and practices during the ICU and post-ICU ward admission in adults who received ECMO. METHODS:A prospective observational study was conducted across ten tertiary hospitals within the ECMO registry (EXCEL) in Australia. Data were collected on day 1 (ECMO initiation), 3, 7 and then 7-daily to day 60. The primary outcome was energy provision (% of clinician-prescribed target). Secondary outcomes were energy delivery (kcal/day), protein delivery (g/day) and protein provision (% of clinician-prescribed target). Mixed-effects linear modelling was used to compare data in the ICU and post-ICU ward setting. RESULTS:147 patients were included between June 2022 and July 2023; 91 (62%) males, mean ± standard deviation age 48 ± 16 y. The median [interquartile range] duration of ECMO was 6 d [4-12], with an ICU and hospital stay of 18 d [10-28] and 27 d [12-48] respectively. Energy delivery was 1223 ± 568 kcal/d in ICU (n = 140) and 1519 ± 765 kcal/d on the post-ICU ward in a subgroup with available data (n = 37), providing 64 ± 26% and 70 ± 34% of energy targets, respectively. Protein delivery was 60 ± 31 g/d in ICU and 72 ± 40 g/d on the post-ICU ward meeting 61 ± 29% and 77 ± 40% of protein targets, respectively. No significant differences were observed between the ICU and post-ICU ward. CONCLUSIONS:Energy and protein delivery were comparable between the ICU and post-ICU ward, consistently remaining below prescribed targets. This may reflect an evidence-based shift early in ICU, but persistent deficits post-ICU may impair recovery and warrant further investigation. STUDY REGISTRATION:https://www.anzctr.org.au/. TRIAL ID:ACTRN12623000304639.

Protein pathways underlying ARDS phenotypes are not fully elucidated. The aim of this subanalysis of an international randomized controlled clinical trial, which assessed the potential benefit of a maximal lung recruitment strategy, was to identify protein signatures in serum and bronchoalveolar fluid associated with ARDS phenotypes and to improve understanding of the underlying biological pathways. Whole proteomic profiling of serum and bronchoalveolar fluid was performed in 50 and 21 ARDS patients, respectively, and compared with 24 non-ARDS controls. ARDS patients were classified as hyperinflammatory (Hyper; n = 17) or hypoinflammatory (Hypo; n = 33) according to a previously validated three-variable classifier model. Sampling for proteomic analysis was performed at study inclusion, before any study intervention. Protein signatures differentiating hyper- and hypoinflammatory ARDS from controls consisted of 19 proteins in serum and 17 proteins in bronchoalveolar fluid. Proteins that are part of the acute phase response signaling pathway and the complement cascade were more highly expressed in Hypo than in Hyper. Canonical pathway analysis showed that inflammatory pathways, including the complement cascade, acute phase response, and cachexia signaling, were activated to a greater extent in Hypo than in Hyper. For some key molecules, canonical pathways and upstream regulators demonstrated different directions of activation between serum and bronchoalveolar fluid. Distinct ARDS phenotypes are associated with different early proteomic patterns in both serum and bronchoalveolar fluid. Inflammatory pathways and upstream regulators were more pronounced in the hypoinflammatory ARDS phenotype. Trial registration: ClinicalTrials.gov, NCT01667146

Objective:To determine the documentation of right ventricular dysfunction (RVD) in mechanically ventilated patients receiving a noradrenaline infusion, and to assess the association with in-hospital mortality, length of stay (LOS) and treatment intensity. Design and setting:This single-centre, retrospective, observational cohort study included patients admitted to the intensive care unit (ICU) between January 2020 and December 2023, with elevated serum lactate levels, who received invasive mechanical ventilation and an intravenous noradrenaline infusion, within the first 7 days. Interventions:Exposure was defined on the basis of documentation of RVD in the medical record; e.g. those with RVD vs those without RVD. Main outcome measures:The primary outcome was in-hospital mortality. Secondary outcomes included ICU mortality, ICU and hospital LOS, organ support modalities, and the utilisation of echocardiography. Comparison between groups utilised logistic and linear regression models. Results:Of 1234 patients included in the study, 273 had documented RVD (22.1%). There was no difference in crude in-hospital mortality (RVD, 24.9% vs no RVD, 23.6% p = 0.66) between groups. Risk-adjusted in-hospital (odds ratio [OR]: 1.65: 1.13-2.41, p = 0.01) and ICU mortality (OR: 1.88: 1.26-2.81, p = 0.002) were greater in those with documented RVD. Median ICU (13.4 vs 10.2 days, p = 0.001) and hospital (25.1 vs 22.5 days, p = 0.002) LOS were significantly longer in the RVD group. A greater number of interventions were provided in those with RVD, including: inhaled nitric oxide (39.6% vs 7.8%, p < 0.001), epoprostenol (1.8% vs 0.1%, p < 0.001), milrinone infusion (77.3% vs 23.6%, p < 0.001), continuous renal replacement therapy (48.7% vs 25.8%, p < 0.001), and extracorporeal membrane oxygenation (33.7% vs 10.4%, p < 0.001). The median number of transthoracic (TTE) or transoesophageal echocardiography (TOE) was 3 (interquartile range [IQR]: 1-4) in those with RVD, compared to 1 (IQR: 1-2) in those without RVD (p < 0.001). Conclusion:Approximately 1 in 4 patients who were mechanically ventilated and receiving noradrenaline had documented RVD, which was associated with a higher risk-adjusted in-hospital mortality, longer LOS, and greater treatment intensity.

OBJECTIVES:The mortality among patients admitted with sepsis remains high and varies depending on the site of infection. The impact of hypercapnia and acidemia on clinical outcomes in mechanically ventilated patients with sepsis is not well understood. DESIGN:Multicenter, binational, retrospective study assessed the association of compensated hypercapnia, hypercapnic acidemia, and nonrespiratory acidemia, in mechanically ventilated patients with mortality in sepsis. SETTING:Data were extracted from the "Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation adult patient" database over a 17-year period (from January 2006 to December 2022) from 201 ICUs. PATIENTS:Patients were classified into four mutually exclusive groups based on a combination of arterial pH and arterial C o2 recorded during the first 24 hours of ICU stay: normocapnia with normal pH, fully compensated hypercapnia, hypercapnic acidemia, and nonrespiratory acidemia. Logistic regression and Cox proportional hazards regression were used to examine the association of compensated hypercapnia, hypercapnic, and nonrespiratory academia to hospital mortality. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Fifty-two thousand four hundred five patients were included. Overall compensated hypercapnia (odds ratio [OR], 1.39; 95% CI, 1.24-1.55; p < 0.001), hypercapnic acidemia (OR, 1.68; 95% CI, 1.57-1.80; p < 0.001), and nonrespiratory acidemia (OR, 1.75; 95% CI, 1.61-1.90; p < 0.001) was associated with increased risk of hospital mortality as compared with patients with normocapnia and normal pH. The risk of increased hospital mortality associated with hypercapnic and nonrespiratory acidemia persisted in all prespecified diagnostic subgroups when compared with patients who had normal pH and normocapnia. Compensated hypercapnia was associated with increased mortality risk in neurologic and unspecified subgroups of sepsis. CONCLUSIONS:Hypercapnic acidemia and nonrespiratory acidemia within the first 24 hours of ICU admission are associated with increased risk of hospital mortality in mechanically ventilated patients with sepsis. This association remains consistent in all diagnostic subgroups of sepsis.

Australian general medicine perioperative services provide care to surgical patients with complex comorbidities, for a wide range of medical conditions. Heterogeneous models of care exist; however, their cost-consequence has not been evaluated. Cost analysis was conducted using nationally standardised cost weights for length of stay, medical emergency team call costs and labour costs. Proactive models of general medicine perioperative care likely save approximately $7500 per patient compared with reactive models.

Objectives To analyse the utility of adding multiparametric magnetic resonance imaging (mpMRI) with 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in detection of local recurrence (LR) and distant recurrence (DR) in patients with biochemical recurrence (BCR), by describing detection rates over time since radical prostatectomy (RP), describing detection rates at differing prostate-specific antigen (PSA) intervals, and identifying clinicopathological factors that predict detection of recurrence on imaging. Patients and Methods Patients with BCR after RP were identified from 2016 to 2020. Kaplan-Meier analysis was performed for LR and DR on mpMRI, 68Ga-PSMA PET/CT, and paired/combined scans, and multivariate regression was performed identifying predictors of LR and DR. Results A total of 117 patients underwent 150 sets of paired scans for BCR after RP, at PSA thresholds 0.2, 0.5, and 1.0 ng/mL. The 68Ga-PSMA PET/CT had higher detection rates of DR at PSA levels of <0.2, 0.2-0.5, 0.5-1.0, and >1.0 ng/mL vs mpMRI (6.1%, 10%, 25% and 36% vs 3%, 6.7%, 6.3%, and 24%, respectively). Meanwhile, mpMRI had higher detection rate of LR than 68Ga-PSMA PET/CT (30.3%, 33.3%, 40.6%, and 40% vs 0%, 13.3%, 18.8%, and 32%, respectively). The detection rate for LR was significantly higher on MRI compared to PSMA at PSA levels of <0.2 and 0.2-0.5 ng/mL (P < 0.001 and P = 0.001, respectively). The detection rate for DR was significantly higher on PSMA than MRI at PSA levels of 0.5-1.0 ng/mL (P = 0.039). On multivariate analysis, PSA velocity was a statistically significant predictor of both LR and DR on MRI alone, PSMA alone, and combined results of paired PSMA and MRI, and International Society of Urological Pathology grade was a statistically significant predictor of DR on MRI. Conclusion The mpMRI had a higher detection rate for LR, while 68Ga-PSMA PET/CT had a higher detection rate for DR. PSA velocity was a significant predictor of both LR and DR on both imaging modalities. In BCR after RP, addition of mpMRI with 68Ga-PSMA PET/CT may improve diagnosis of recurrent lesions and patient selection for treatment.

Abstract Background and objective Radical cystectomy (RC) is standard for muscle‐invasive disease (MIBC) and utilised frequently in high‐risk non‐muscle‐invasive bladder cancer (NMIBC). Pelvic lymph node dissection (PLND) is routinely performed during RC for MIBC, demonstrating a survival benefit. However, the oncologic value in NMIBC remains uncertain. As such, a systematic review was conducted to determine whether PLND confers an oncologic benefit in NMIBC patients undergoing RC. Materials and methods A systematic search of MEDLINE, Embase and PubMed (January 1989–January 2025) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines (CRD42023443011). Eligible studies included NMIBC patients undergoing RC with or without PLND. Data extraction and quality assessment (ROBINS‐I, MINORS) were performed independently by two reviewers. Results Twenty‐one retrospective studies (n = 35 793) met inclusion criteria. Lymph node positivity ranged from 0% to 13%. Comparative studies consistently demonstrated improved overall survival and cancer‐specific survival with PLND, particularly among pT1 subgroups (pooled 5‐year OS = 71.8%, 95% CI 59.3–84.3). Several studies demonstrated a dose–response association between lymph node yield or dissection extent and improved outcomes. Benefits were inconsistent for Ta/Tis disease. Pathological upstaging occurred in 16%–36% of clinically staged cohorts. However, study quality was moderate, with heterogeneity in PLND definitions, staging methods and adjuvant treatment use. Conclusions PLND appears to improve staging and survival in high‐risk NMIBC, especially pT1 disease. Routine PLND for low‐risk Ta/Tis disease is unsupported. Standardised definitions of PLND extent and prospective evaluation are needed to confirm its therapeutic role.

Prostate cancer is the most commonly diagnosed malignancy among Australian men and survivorship care represents an increasingly important component of urological practice [...]

BACKGROUND:Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Stevens-Johnson Syndrome (SJS), and Toxic Epidermal Necrolysis (TEN) are life-threatening adverse medication reactions, often with multiorgan involvement. Cardiac involvement in these conditions has not been well-characterised. OBJECTIVES:To evaluate the prevalence, clinical spectrum, and outcomes of cardiac involvement in patients diagnosed with DRESS and SJS/TEN. METHODS:A single-centre retrospective cohort study was conducted. DRESS and SJS/TEN patients between January 2014 and January 2024 were identified through the hospital adverse drug reaction database. Cardiac involvement was defined as the presence of cardiac symptoms accompanied by any new abnormality detected on electrocardiograms, cardiac biomarkers, and/or cardiac imaging during admission. RESULTS:58 patients were included: 79 with DRESS and 79 with SJS/TEN. Cardiac involvement was identified in 15.2% of DRESS and 6.3% of SJS/TEN cases. Cardiovascular risk factors were prevalent across both conditions with hypertension being the most common. Cardiac symptoms were reported in up to 20% with dyspnoea being the most frequent. Of those who had cardiac investigations, new electrocardiographic abnormalities were detected in up to 42% of patients. ICU admissions and mortality were higher in SJS/TEN but there was no mortality attributable to cardiac involvement. Antibiotics were the most frequently implicated medications in both groups.In DRESS subgroup analysis, cardiac involvement was associated with higher rates of renal involvement (100% vs 64%, p = 0.014) and ICU admission (67% vs 34%, OR = 3.83, 95% CI 1.04-14.07, p = 0.043), but was less common with antibiotics exposure as a cause of DRESS (58% vs 84%, OR = 0.28, 95% CI 0.07- 1.03, p = 0.055). CONCLUSION:Cardiac involvement is an under-recognised but clinically important feature of DRESS and SJS/TEN. Findings highlight the contribution of cardiac dysfunction to morbidity and support routine cardiac assessment in patients with SCAR. Larger prospective studies and national drug reaction registries are needed to better define burden and guide care.

Background Drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening adverse medication reactions, often with multiorgan involvement. Cardiac involvement in these conditions has not been well characterized.Objectives To evaluate the prevalence, clinical spectrum and outcomes of cardiac involvement in patients diagnosed with DRESS and SJS/TEN.Methods A single-centre retrospective cohort study was conducted. Patients with DRESS or SJS/TEN seen between January 2014 and January 2024 were identified through the hospital adverse drug reaction database. Cardiac involvement was defined as the presence of cardiac symptoms accompanied by any new abnormality detected on electrocardiograms, cardiac biomarkers and/or cardiac imaging during admission.Results In total, 158 patients were included: 79 with DRESS and 79 with SJS/TEN. Cardiac involvement was identified in 15% of cases of DRESS and 6% of cases of SJS/TEN. Cardiovascular risk factors were prevalent across both conditions, with hypertension being the most common. Cardiac symptoms were reported in up to 20% of cases, with dyspnoea being the most frequent. Of those who had cardiac investigations, new electrocardiographic abnormalities were detected in up to 42% of patients. Intensive care unit (ICU) admissions and mortality were higher with SJS/TEN, but there was no mortality attributable to cardiac involvement. Antibiotics were the most frequently implicated medications in both groups. In the DRESS subgroup analysis, cardiac involvement was associated with higher rates of renal involvement (100% vs. 64%, P = 0.01) and ICU admission [67% vs. 34%, odds ratio (OR) 3.83, 95% confidence interval (CI) 1.04-14.1; P = 0.04], but was less common with antibiotic exposure as a cause of DRESS (58% vs. 84%, OR 0.28, 95% CI 0.07-1.03; P = 0.06).Conclusions Cardiac involvement is an under-recognized but clinically important feature of DRESS and SJS/TEN. Our findings highlight the contribution of cardiac dysfunction to morbidity and support routine cardiac assessment in patients with severe cutaneous adverse reactions. Larger prospective studies and national drug reaction registries are needed to better define the burden and guide care. Drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe drug reactions with multisystem involvement. In this single-centre retrospective study (2014-2024, n = 158), cardiac involvement occurred in 15% of cases of DRESS and 6% of cases of SJS/TEN. In the group with DRESS, cardiac involvement correlated with renal dysfunction and intensive care unit admission. The findings highlight the need for routine cardiac evaluation in severe cutaneous adverse reactions.

Background: Burn patients are highly susceptible to hospital-acquired infections (HAIs), and contaminated near-patient surfaces can act as reservoirs for multidrug-resistant organisms (MROs). Ultraviolet-C (UV-C) room disinfection is increasingly used as an adjunct to manual cleaning, but real-world data in adult burns settings remain limited. Methods: We evaluated adjunctive UV-C disinfection in a tertiary adult trauma and burns surgical ward using a two-part observational design. Part A compares MRO-related HAI incidence before UV-C implementation (12 May 2015-11 May 2020; retrospective) with its incidence after implementation (14 July 2020-13 July 2021; prospective). Part B is a matched pre/post environmental sampling study (December 2022-December 2024) of 44 vacant rooms. Paired swabs from a single randomised high-touch surface per room were collected immediately before and after UV-C disinfection and processed by an independent laboratory. Results: Part A included 7589 admissions (6415 before-UV-C; 1174 after-UV-C) with 2728 UV-C cycles delivered after implementation. MRO-related HAI incidence decreased from 18.3 to 10.2 per 1000 bed-days (p < 0.01). In Part B, the proportion of swabs with <10 CFU increased after UV-C disinfection (66% vs. 50%, p = 0.02). Among swabs with non-negligible baseline contamination and excluding increases, the median CFU reduction was 97% (SD 12%; p < 0.001), with no significant differences in reduction across sampled surface types. Conclusion: In an adult burns surgical ward, adjunctive UV-C disinfection was associated with reduced MRO-related HAI incidence and a substantial reduction in environmental bioburden on high-touch surfaces. These real-world findings support UV-C as a feasible adjunct to standard cleaning in high-risk burn services and inform future controlled evaluations.

Introduction:A key dogma in the management of extensive-stage SCLC (ES-SCLC) is rapid diagnosis and treatment. However, the impact of treatment timeliness in a real-world setting is incompletely understood. Methods:Patients with ES-SCLC were identified from the Victorian Lung Cancer Registry (VLCR). Referral-to-diagnosis, referral-to-treatment, and diagnosis-to-treatment intervals were calculated and defined as timely if they were less than 28 days, 42 days, and 14 days, respectively. The impact of timeliness on overall survival was determined using univariable and multivariable Cox proportional hazards regression. Results:From January 2012 to April 2023, the VLCR enrolled 1195 patients with ES-SCLC, including 995 who were treated with chemotherapy. The median referral-to-diagnosis, referral-to-treatment, and diagnosis-to-treatment intervals were 8 days (interquartile range [IQR] 4-17 days), 18 days (IQR 10-31 days), and 7 days (IQR 4-13 days), respectively. Mortality risk was greater with a shorter diagnosis-to-treatment time (hazard ratio [HR], 1.31 for <14 days versus ≥14 days; 95% confidence interval [CI]: 1.12-1.54; p = 0.001), which was corroborated by multivariable regression (adjusted HR, 1.32; 95% CI: 1.13-1.56; p = 0.001). Poorer survival was also observed with a shorter referral-to-diagnosis interval (adjusted HR, 1.37 for <28 days versus ≥28 days; 95% CI: 1.10-1.71; p = 0.005) and shorter referral-to-treatment interval (adjusted HR, 1.58 for <42 days versus ≥42 days; 95% CI: 1.28-1.95; p <0.0001). Conclusion:Most patients captured in the VLCR received timely care. Although earlier treatment predicted worse overall survival, the effects of timely care on symptom control and quality of life remain important considerations that require further characterization.

INTRODUCTION:Low skeletal muscle is prevalent and associated with poorer outcomes after oesophagogastric (OG) cancer surgery. However, sarcopenia, including strength and function, is less commonly assessed. Therefore, we aimed to describe the prevalence of sarcopenia and changes in diagnostic criteria within 1 year of OG cancer surgery. METHODS:This prospective observational study included OG cancer surgery patients from 2018 to 2021. Body composition was assessed using computed tomography (CT) and bioimpedance spectroscopy (BIS). Low CT-defined skeletal muscle index (SMI) and myosteatosis were defined using published thresholds. Low fat-free mass index (FFMI) cut points were < 17 kg/m2 for men and < 15 kg/m2 for women. Hand grip strength (HGS, kg) and 6-metre walk test (metres/second) measured strength and function, respectively. Sarcopenia, defined using the European Working Group on Sarcopenia in Older People 2019 criteria, was assessed preoperatively, 2-, 6- and 12-weeks post-discharge and 6 and 12 months postoperatively. RESULTS:Forty-eight patients, predominantly male (63%) with a mean (SD) age of 64 (10.1) years, were included preoperatively, and 25 patients at 1 year. Low SMI (50%) and myosteatosis (50%) were prevalent preoperatively. Fewer patients had low FFMI (6%), low HGS (17%), and low walk speed (6%). The prevalence of Sarcopenia-CT was 15% preoperatively and 12% at 1-year (p = 0.32), and sarcopenia-BIS was 2% preoperatively and 3% at 1-year (p = 0.60). CONCLUSIONS:Despite a high prevalence of low SMI and myosteatosis, sarcopenia was less common. Low muscle mass, with adequate strength and function, is a prominent feature. Given the negative outcomes of low SMI, muscle assessment remains a valuable and clinically meaningful measure.