Can sarcopenia predict poor prognosis of sepsis due to biliary sepsis?

Aim of the study: Sepsis is a life-threatening disease, contributing to significant morbidity and mortality. This study aimed to investigate the association between sarcopenia and the prognosis of patients with biliary sepsis, focusing on outcomes such as length of hospital stay (LOS), intensive care unit (ICU) admission, and in-hospital mortality. Methods This retrospective, single-center, observational study included adult patients with biliary sepsis who visited the emergency department between January 2016 and December 2021. Sarcopenia was assessed using the psoas muscle index (PMI). Using computed tomography imaging, the area of both sides of the psoas muscle at the L3 level was measured, and the PMI, corrected by the patient’s height was calculated. The primary outcome was in-hospital mortality, and the secondary outcomes were intensive care unit (ICU) admission, LOS, and 14-day mortality. Results A total of 745 patients were included in this study. Sarcopenia was defined as a PMI < 421 mm 2 /m 2 for males and < 268 mm 2 /m 2 for females with the lower quartile of PMI according to sex. The cohort was classified into sarcopenic (n = 189) and non-sarcopenic (n = 556) groups. There was a significant association between sarcopenia and in-hospital mortality (odds ratio, 3.81; 95% confidence interval, 1.08–13.47), while there was no significant association between sarcopenia and ICU admission. In addition, the median LOS in the sarcopenic group (10 [7–14] days) was significantly longer than the median (8 [6–11] days) in the non-sarcopenic group. Conclusions Sarcopenia was significantly associated with clinical outcomes, particularly in-hospital mortality and LOS, in patients with biliary sepsis.