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A High Visceral-To-Subcutaneous Fat Ratio is an Independent Predictor of Surgical Site Infection after Gastrectomy

Authors
 Jung Ho Kim  ;  Jinnam Kim  ;  Woon Ji Lee  ;  Hye Seong  ;  Heun Choi  ;  Jin Young Ahn  ;  Su Jin Jeong  ;  Nam Su Ku  ;  Taeil Son  ;  Hyoung-Il Kim  ;  Sang Hoon Han  ;  Jun Yong Choi  ;  Joon-Sup Yeom  ;  Woo Jin Hyung  ;  Young Goo Song  ;  Sung Hoon Noh 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.8(4) : E494, 2019 
Journal Title
JOURNAL OF CLINICAL MEDICINE
Issue Date
2019
Keywords
body composition ; gastrectomy ; gastric cancer ; outcomes ; risk factors ; surgical site infection ; visceral-to-subcutaneous fat ratio
Abstract
Recent studies have shown that body composition is an important factor that affects surgical site infection (SSI). However, each study has utilized different body composition criteria. Therefore, in this study, we aim to determine the most predictable body composition criteria for the prediction of SSI after gastrectomy. The visceral fat area (VFA), subcutaneous fat area (SFA), and muscle area were assessed by a preoperative-stage computed tomographic (CT) scan. To compare the predictive performance of body composition for SSI, logistic regression models were used, and the models were compared using the receiver operation characteristic (ROC) curve and the area under the curve (AUC) value. Of the 1038 eligible patients, 58 patients (5.6%) developed SSI. The VFA-to-SFA ratio showed the best predictive performance (mean AUC 75.11). The cutoff value for the SSI of the VFA-to-SFA ratio was 0.94, and the sensitivity and specificity were 67.86% and 77.65%, respectively. A multivariate logistic analysis indicated that a total gastrectomy (OR, 2.13; p = 0.017), stage III or IV cancer (OR, 2.66; p = 0.003), and a high VFA-to-SFA ratio (OR, 8.09; p < 0.001) were independent risk factors for SSI after gastrectomy. The VFA-to-SFA ratio is the most predictable body composition model for use in predicting the incidence of SSI after gastrectomy.
Files in This Item:
T201901144.pdf Download
DOI
10.3390/jcm8040494
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Kim, Jin Nam(김진남)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Seong, Hye(성혜) ORCID logo https://orcid.org/0000-0002-5633-7214
Son, Tae Il(손태일) ORCID logo https://orcid.org/0000-0002-0327-5224
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Yeom, Joon Sup(염준섭) ORCID logo https://orcid.org/0000-0001-8940-7170
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Choi, Heun(최흔) ORCID logo https://orcid.org/0000-0002-9622-9381
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169833
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