151751-Najiba-Chargi

150 CHAPTER 8 Table 7. Multivariate analysis of longer hospital stay for patient variables Patient variables Length of hospital stay ratio (95% CI) p value Overall p value ACE-27 a 0 Ref. 0.01 1 0.97 (0.91-1.04) 0.41 2 1.06 (0.99-1.14) 0.09 3 1.05 (0.94-1.18) 0.40 ASA classification b 1 Ref. 0.02 2 1.08 (1.0-1.2) 0.06 3+ 1.15 (1.0-1.3) 0.005 Alcohol use > 3 U/day 0.99 (0.935-1.042) 0.63 0.76 Sporadic 0.98 (0.915-1.042) 0.47 No Ref. Operating time 1.04 (1.03-1.05) <0.001 - Decrease in Hb c level 1.04 (1.02-1.06) 0.001 - BMI d 1.0 (0.99-1.00) 0.08 - Sarcopenia Yes 1.04 (0.98-1.10) 0.26 - No Ref. Variables with p < 0.05 were considered significant. a ACE-27 = Adult Comorbidity Evaluation-27, b ASA classification, c Hb = hemoglobin, d BMI = Body Mass Index DISCUSSION Our first hypothesis was confirmed: we found a significant association between SMM and presence of perioperative complications (OR 2.61) and number (OR 2.43) of perioperative complications, which means that sarcopenia is an independent predictive factor for periop- erative complication rate. To the best of our knowledge this is the first study on the relation between sarcopenia and perioperative complications in surgically treated OSCC patients. In recent studies, a similar relation was found for sarcopenia on the occurrence of fistula after laryngectomy and complications after fibula reconstruction in head and region. 18,21,22 Also, a recent study in 125 OSCC patients who underwent curative surgery, found a significant prog - nostic impact of sarcopenia for decreased disease-free and overall survival. Perioperative complication rate was also associated with longer operating time, increased blood loss and ACE 27. These findings were in concordance with Peters et al. 33 We evaluated comorbidity using both ASA physical status classification system and ACE-27 index. The ASA physical status classification system is a widely used validated grading system to identify perioperative risk for anesthesiologists. 34 The ACE-27 index is a validated index 28,29,35,36 developed to identify the important medical comorbidities and to grade the