Associação entre índices inflamatórios periféricos e o risco de sarcopenia em pacientes submetidos a cirurgia eletiva

Abstract

Background & Aims: Sarcopenia is increasingly relevant in the surgical setting, being associated with higher mortality, prolonged hospital stay, and worse postoperative outcomes. Low-grade systemic inflammation links aging, malnutrition, and muscle loss, but cytokinebased assessment is costly and scarcely available. Blood-count-derived inflammatory indices (SII, SIRI, NLR, MLR, PLR, RDW) are low-cost alternatives, yet their relationship with sarcopenia risk in surgical patients remains poorly explored. This study evaluated the association between systemic inflammatory indices and sarcopenia risk in elective surgery patients, and their discriminatory ability to identify at-risk individuals. Methods: This retrospective cross-sectional study included 293 patients aged ≥18 years admitted for elective surgery at a Brazilian university hospital (2022–2025). Sarcopenia risk was assessed using SARC-F combined with calf circumference (SARC-F+CC). Inflammatory indices were calculated from preoperative complete blood counts. ROC curves determined optimal cutoffs, and multivariable logistic regression models evaluated the independent association of SII and SIRI with sarcopenia risk. Results: Of 293 patients, 38 (13%) were at risk of sarcopenia. This group was older, with lower BMI, reduced calf circumference, more nutritional risk and diabetes, and longer hospital stay and mortality. MLR, NLR, and PLR were significantly higher among at-risk patients; SII, SIRI, and RDW showed a similar, non-significant trend. Discriminatory performance was modest (AUC 0.592–0.607). After full adjustment, continuous SII remained independently associated with sarcopenia risk (OR=1.45), as did categorized SII (OR=2.69) and SIRI (OR=2.45). Conclusions: Hemogram-derived inflammatory indices, particularly SII, were independently associated with sarcopenia risk in elective surgery patients. Despite modest discriminatory performance, these low-cost biomarkers may complement preoperative nutritional assessment and support early identification of at-risk patients.