Sarcopenia independently predicts acute cholecystitis in older patients with gallstones: a retrospective cohort study

Background: This study investigated whether sarcopenia independently predicts incident acute cholecystitis (AC) in geriatric patients with gallstones. Methods: This retrospective cohort study included 1,177 patients aged ≥65 years with incidentally detected gallstones and no prior biliary disease. Sarcopenia was diagnosed using Asian Working Group for Sarcopenia 2019 criteria. The primary outcome was AC development during follow-up, adjudicated using Tokyo Guidelines 2018. Multivariate logistic and Cox regression models adjusted for age, BMI, sex, alcoholism, and Charlson Comorbidity Index.7. Results: < 0.001). Severe sarcopenia did not confer additional risk beyond standard sarcopenia criteria. Conclusions: Sarcopenia is a robust, independent predictor of AC development in older adults with gallstones, offering superior risk stratification compared to adiposity-based metrics. Routine sarcopenia assessment may identify high-risk individuals for targeted preventive interventions.