THE IMPACT OF SARCOPENIA AND VISCERAL OBESITY ON IN-HOSPITAL MORTALITY IN ELDERLY PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH SEPSIS

Introduction: Sepsis remains a leading cause of morbidity and mortality in elderlyadults, with early risk stratification posing a significant challenge. This study aims to investigate the association between sarcopenia and visceral obesity and in-hospital mortality in elderly septic patients. Materials and Method:This retrospective single-centre study included patients aged ≥65 years who presented to the emergency department with suspected infection and met the Sepsis-3 criteria. Data collected included demographics, comorbidities, infection site, body mass index, lactate and procalcitonin levels, Acute Physiology and Chronic Health Evaluation II scores, and Sequential Organ Failure Assessment scores. Abdominal computed tomography scans at admission were analysed to assess sarcopenia, defined by the Skeletal Muscle Index, and visceral obesity, determined by an elevated visceral-to-subcutaneous adipose tissue ratio. Results: 453 patients were included (mean age, 67.8 ± 1.8 years; 55.2% female), with an in-hospital mortality rate of 42.9%.Non-survivors had significantly elevated Acute Physiology and Chronic Health Evaluation II scores, Sequential Organ Failure Assessment scores, serum lactate levels, and procalcitonin levels (all p < 0.001).Non-survivors also had significantly lower Skeletal Muscle Index and higher visceral-to-subcutaneous adipose tissue ratio values than survivors (p <0.001). The optimal cut-off values for predicting mortality were <32.65 cm²/ m² for Skeletal Muscle Index and >2.15 for visceral-to-subcutaneous adipose tissue ratio.Logistic regression showed that diabetes mellitus and malignancy were independent predictors of mortality. Conclusion: Computed tomography-derived sarcopenia and visceral obesity are independent predictors of in-hospital mortality in elderly septic patients. These parameters may enhance early risk stratification in the emergency department. Keywords: Sepsis; Sarcopenia; Intra-Abdominal Fat; Tomography; Aged; Mortality.