Traditional surgical risk assessment often relies on body mass index (BMI) as a surrogate of adiposity. However, BMI fails to account for variations in body composition — particularly the distribution of fat and muscle — and may obscure important clinical phenotypes. One such phenotype is sarcopenic obesity (SO), defined as the coexistence of excess adiposity and low skeletal muscle mass and function. There is a growing recognition and prevalence of SO with estimates as high as 26.3%, owing to an ageing population and a global obesity epidemic. There is an emerging interest to further understand the risk profile of SO patients undergoing surgery, combining the metabolic, inflammatory burdens of obesity with the frailty associated with sarcopenic. Some evidence from small scale single centre studies have suggested that SO may be associated with increased postoperative morbidity and mortality, particularly in cancer surgery. There is a critical need to move beyond BMI and explore how body composition –specifically SO– influences surgical outcomes on a population level. Using the UK Biobank we aim to utilise linked surgical and body composition data to evaluate whether SO increased all-cause mortality after major abdominal cancer surgery and to determine whether there was an increased incidence of major post-operative complications.
Specific objectives of this work are the following:
to determine if SO was associated with increased 30 and 90 day all-call mortality
to determine if SO was associated with increased 30 day post operative comorbidity such as (e.g. thromboembolic events, myocardial infarction, cerebrovascular events, haematological emergencies such as disseminated intravascular coagulopathy, pulmonary oedema, pneumonia and sepsis)
to determine if SO was associated with increased intensive care admission or readmission
to determine if SO was associated with prolonged hospital length of stay postoperatively