P0365 The Prognostic Impact of Sarcopenia on Surgical Outcomes and Postoperative Recurrence After Ileocolic Resection in Crohn’s Disease

Sarcopenia is defined as a quantitative and qualitative reduction of muscle mass. Recent evidence suggests that in Crohn’s disease (CD), muscle depletion may increase the risk of postoperative complications and disease recurrence. Sarcopenia can be assessed using indices derived from CT or MRI, such as the Total Psoas Area Index (TPAI), calculated at the level of the third lumbar vertebra on radiologic scans. The study aims to evaluate the prognostic role of preoperative sarcopenia on surgical outcomes and on endoscopic recurrence at 6–12 months in CD patients after ileocolic resection. CD patients undergoing ileocolic resection between 2017 and 2024 were enrolled. Sarcopenia was defined as TPAI lower than 5.4 cm²/m² for men and 3.56 cm²/m² for women, assessed on MRI or CT scans performed within 3 months prior to surgery. Postoperative complications were evaluated using the Clavien–Dindo classification (CDs ≥2). Endoscopic recurrence (ER) was assessed using the Rutgeerts score (RS ≥ i2) at 6–12 months after surgery. We retrospectively enrolled 152 patients, with a preoperative prevalence of sarcopenia of 40.1%. The mean BMI was 22.26 kg/m² (±3.63). The mean age at surgery was 43.24 years (±15). Early postoperative complications (PC) occurred in 25.7% of cases, while ER at 6–12 months was observed in 50.7%. The presence of sarcopenia was significantly associated with PC (39% vs 16, p = 0.002) and with ER(62% vs 42% p = 0.019). In multivariate logistic regression, the factors independently associated with ER were: Sarcopenia: OR 2.26 (95% CI 1.06–4.85, p = 0.036); Active smoking: OR 2.32 (95% CI 1.12–4.81, p = 0.024); Previous surgeries: OR 2.21 (95% CI 1.01–4.86, p = 0.047) In our study, preoperative sarcopenia emerged as a potentially predictor of both early surgical complications and postoperative disease recurrence in Crohn’s disease. Conflict of interest: Dr. Del Gaudio, Angelo: No Di Vincenzo, Federica: No conflict of interest Murgiano, Marco: No conflict of interest Cascella, Fabio: No conflict of interest Becherucci, Guia: No conflict of interest Parello, Simone: No conflict of interest Fiaccavento, Flavio: No conflict of interest Di Certo, Teodoro Pietro: No conflict of interest Massimo, Musumeci: No conflict of interest Coppola, Gaetano: No conflict of interest Mignini, Irene: No conflict of interest Foscarini, Elisa: No conflict of interest Francesca, Profeta: No conflict of interest Puca, Pierluigi: No conflict of interest Laterza, Lucrezia: No conflict of interest Napolitano, Daniele: No conflict of interest Schiavoni, Elisa: No conflict of interest Sacchetti, Franco: No conflict of interest Caprino, Paola: No conflict of interest Sofo, Luigi: No conflict of interest Gasbarrini, Antonio: No conflict of interest Pugliese, Daniela: No conflict of interest Lopetuso, Loris Riccardo: Personal Fees: none Minordi, Laura Maria: No conflict of interest Scaldaferri, Franco: Consultancy fee/board for Janseen, Takeda, Pfizer, MSD, Sandoz, Galapagos, Celltrion, Ferring, Abbvie, Lilly, Alfasigma, Abivax