Prevalence and Impact of Sarcopenia on Postoperative Outcomes in Major Abdominal Surgery

Background: Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, has emerged as a clinically significant factor influencing surgical outcomes. It is increasingly recognized as a predictor of morbidity and prolonged recovery in patients undergoing major abdominal procedures. However, limited data exist from Indian cohorts, particularly in resource?limited settings, where preoperative risk stratification is crucial. Objective: To evaluate the predictive role of sarcopenia in postoperative complications among patients undergoing major abdominal surgery at a tertiary care center. Methods: A prospective observational study was conducted at Velammal Medical College and Hospital, Madurai, between 1 September 2024 to 1 September 2025. Thirty adult patients undergoing elective or emergency major abdominal surgery were enrolled. Sarcopenia was assessed using [insert diagnostic method: CT?based muscle index or handgrip strength]. Postoperative complications within 30 days were documented and graded according to the Clavien–Dindo classification. Statistical analysis included descriptive measures, chi?square testing, and logistic regression to identify predictors. Results: Sarcopenia was present in 12 patients (40%). Postoperative complications occurred in 14 patients (46.7%), with significantly higher rates among sarcopenic patients (9/12, 75%) compared to non?sarcopenic patients (5/18, 27.8%; p=0.01). Sarcopenia was associated with prolonged hospital stay (12.4 ± 3.6 vs 8.2 ± 2.9 days, p=0.02) and increased ICU admissions (41.7% vs 11.1%). No mortality was observed during the study period. Conclusion: Sarcopenia is a strong predictor of postoperative complications, longer hospitalization, and ICU requirement in patients undergoing major abdominal surgery. Routine preoperative screening for sarcopenia may enhance risk stratification, guide perioperative optimization, and improve surgical outcomes in Indian practice. Keywords: sarcopenia; abdominal surgery; postoperative complications; risk prediction; Clavien–Dindo classification.