Weak grip, weak anastomosis? Handgrip strength and sarcopenia as predictors of anastomotic leakage after colorectal cancer surgery

Table 1 Comparison of baseline demographic and clinical characteristics between included and excluded patients, mean ± SD/n (%)

Variable	Included, n = 117	Excluded, n = 271	P value
Age in years	64.8 ± 12.9	66.1 ± 13.5	0.370
BMI (kg/m2)	26.7 ± 2.6	26.3 ± 2.8	0.175
ASA score	2.5 ± 0.7	2.6 ± 0.8	0.217
Female sex	44 (37.6)	108 (39.9)	0.762
Tumor location: Right/Left/rectum	42/20/55	96/44/131	0.964
Anastomotic leakage, 30-day	14 (12.0)	29 (10.7)	0.726

Excluded patients primarily lacked retrievable preoperative handgrip strength data. Continuous variables are presented as mean ± SD, and categorical variables as n (%) or n. Between-group comparisons were performed using Welch’s t-test for continuous variables and Pearson’s χ² test or Fisher’s exact test for categorical variables, as appropriate. BMI: Body mass index; ASA: American Society of Anesthesiologists.

Table 2 Demographic, clinical, and operative characteristics according to anastomotic leakage status, mean ± SD/n (%)

Variable	No AL (n = 103)	AL (n = 14)	P value
Age in years	64.5 ± 12.8	67.2 ± 13.4	0.360
Female sex	36 (35.0)	8 (57.1)	0.130
BMI (kg/m2)	26.9 ± 2.5	25.4 ± 2.1	0.090
ASA score	2.4 ± 0.7	3.1 ± 0.8	0.020
Sarcopenia	39 (37.8)	9 (64.3)	0.040
Handgrip strength (kg)	27.5 ± 4.9	19.4 ± 3.8	< 0.001
Operative time (minutes)	178.6 ± 24.3	211.5 ± 27.8	0.010
Anastomosis type
Ileocolic	41 (39.8)	1 (7.1)
Colocolic	19 (18.4)	1 (7.1)
High colorectal	21 (20.4)	1 (7.1)
Mid colorectal	14 (13.6)	2 (14.3)
Low colorectal	7 (6.8)	6 (42.9)
Coloanal	1 (1.0)	3 (21.4)

Anastomosis type: P values were not calculated for anastomosis type due to small cell counts across categories. BMI: Body mass index; ASA: American Society of Anesthesiologists; AL: Anastomotic leakage.

Table 3 Univariate logistic regression analysis for predictors of anastomotic leakage

Variable	OR (95%CI)	P value
Sarcopenia	2.75 (1.10-6.89)	0.030
ASA score	1.68 (1.01-2.93)	0.046
Operative time (minutes)	1.01 (1.00-1.02)	0.041
Handgrip strength (kg)	0.89 (0.81-0.99)	0.031
BMI (kg/m2)	0.92 (0.82-1.03)	0.140
Age in years	1.02 (0.98-1.07)	0.290
Male sex	0.76 (0.31-1.89)	0.540

ASA: American Society of Anesthesiologists; BMI: Body mass index; OR: Odds ratio; CI: Confidence interval.

Table 4 Multivariate logistic regression for independent predictors of anastomotic leakage

Variable	OR (95%CI)	P value
Sarcopenia	2.89 (1.18-7.04)	0.018
ASA score	1.74 (1.02-3.01)	0.043
Operative time (minutes)	1.01 (1.00-1.02)	0.036
Handgrip strength (kg)	0.91 (0.83-1.00)	0.049

ASA: American Society of Anesthesiologists; OR: Odds ratio; CI: Confidence interval.