Preoperative Myosteatosis and Perioperative Serum Chloride Levels: Independent Predictors of 180-Day Complications After Radical Cystectomy

Preoperative Myosteatosis and Perioperative Serum Chloride Levels: Independent Predictors of 180-Day Complications After Radical Cystectomy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Preoperative Myosteatosis and Perioperative Serum Chloride Levels: Independent Predictors of 180-Day Complications After Radical Cystectomy WASSAPOL SORNTHAI, THITIPAT HANSOMWONG, ACHIRAYA TEYATEETI, VARAT WORANISARAKUL, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5243839/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 25 Jan, 2025 Read the published version in Scientific Reports → Version 1 posted 10 You are reading this latest preprint version Abstract Objective : This study aimed to investigate the role of myosteatosis, sarcopenia, and perioperative serum biomarkers as independent predictors of major complications within 180 days following radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). Methods : We retrospectively analyzed of 127 MIBC patients who underwent RC between 2013 and 2023 at a single institution. Preoperative body composition was assessed using CT scans at the L3 vertebral level to measure psoas muscle density (PMD), skeletal muscle density (SMD), axial muscle density (AMD), and muscle indices. Novel inflammatory and nutritional markers, including serum chloride levels within 24 hours post-surgery, were also evaluated. Major complications were defined as Clavien-Dindo grade ≥ 3. Multivariate analysis was performed to identify independent predictors of postoperative complications. Results : Among the study cohort, 30.7% of patients experienced major complications within 90 days, and 36.2% within 180 days. Myosteatosis (p = 0.002) and postoperative serum chloride levels (p < 0.001) were significant independent predictors of 180-day major complications. Patients with low PMD had an adjusted odds ratio (OR) of 3.959 for developing major complications, while increased serum chloride levels were associated with a reduced risk of complications (OR = 0.985). Multivariate analysis reveals associations between myosteatosis, aging, and anemia. Conclusion : Myosteatosis and perioperative serum chloride levels are significant predictors of major complications after RC for MIBC. Incorporating body composition analysis and early serum chloride monitoring into perioperative care may improve risk stratification and patient outcomes following RC. Health sciences/Urology/Bladder Health sciences/Risk factors Biological sciences/Cancer/Cancer imaging Health sciences/Diseases/Urogenital diseases/Urological cancer/Bladder cancer myosteatosis skeletal muscle cystectomy serum chlorides postoperative complications Figures Figure 1 Figure 2 Introduction Bladder cancer is the 10th most commonly diagnosed cancer globally and the 13th leading cause of cancer-related mortality 1 . Muscle-invasive bladder cancer (MIBC) presents significant challenges due to its aggressive nature, with about 25% of patients either presenting with or progressing to this advanced stage 2 . Radical cystectomy (RC) remains the standard treatment for patients with MIBC, involving complete bladder removal and creation of either an external urinary diversion or a continent urinary reservoir. Despite its curative potential, RC is associated with substantial postoperative complications, with morbidity and mortality rates ranging between 40–75%, particularly in older individuals 3 – 5 . Several studies have highlighted the importance of identifying risk factors to tailor treatment strategies for these patients. Sarcopenia, characterized by reduced muscle mass has been shown to predict poor cancer prognosis and survival 6 , 7 . However, emerging evidence suggests that muscle quality, particularly myosteatosis (fat infiltration into skeletal muscle), may be an even stronger predictor of adverse surgical outcomes. Myosteatosis has been associated with poorer survival in several cancers, though its role in bladder cancer remains underexplored 8 – 10 . In addition to body composition, novel serum biomarkers representing inflammatory and nutritional status—such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), and prognostic nutritional index (PNI) — have gained attention as potential predictors of postoperative complications 11 – 15 . Among these, serum chloride levels have emerged as significant perioperative markers, with studies suggesting that both hypo- and hyperchloremia can affect surgical outcomes 16 – 20 . Combining these serum markers with imaging biomarkers like sarcopenia and myosteatosis could offer a more comprehensive preoperative risk stratification approach for MIBC patients. Given that preoperative CT scans and serum biomarkers analyses are routinely used for MIBC patients, incorporating these novel predictors into preoperative evaluation can enhance risk assessment. This study aims to assess the predictive value of preoperative sarcopenia, myosteatosis, along with novel serum biomarkers in forecasting major complications using standardized reporting methods. Understanding these relationships could lead to improved patient counseling and personalized prehabilitation strategies, ultimately reducing postoperative complications. Materials and methods Study design and patients This retrospective, single-center cohort study was conducted at Siriraj Hospital, Mahidol University, Bangkok, Thailand, over a 10-year period (January 2013 to June 2023). The study included 127 patients with MIBC who underwent RC. Patients receiving neo-adjuvant cisplatin-based chemotherapy or immune-oncology (IO) treatments were also included. Exclusions criteria comprised patients lacking a preoperative abdominal CT scan within 60 days of surgery, those diagnosed with non-urothelial cancers, patients receiving adjuvant chemotherapy, IO, or radiation within 180 days postoperatively, and those lost to follow-up before the 180-day postoperative period. Routine follow-ups were conducted at 1, 3, and 6 months post-surgery. This study was approved by the Siriraj institutional Review Board. (SIRB 828/2565(IRB1)). Due to the retrospective nature of the study, the Siriraj institutional Review Board waived the need of obtaining informed consent. All methods in this study were conducted in compliance with the relevant guidelines and regulations outlined by Scientific Reports. Data collection Demographic and clinical data were retrieved from medical records, including gender, age at surgery, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, age-adjusted Charlson comorbidity index (ACC index), neoadjuvant treatment (NAT) status, surgical approach (open, laparoscopic or robotic), and type of urinary diversion (cutaneous ureterostomy, ileal conduit, or neobladder). Postoperative complications were categorized using the Clavien-Dindo classification (CDC), with major complications defined as grade 3 or higher. Length of hospital stay (LOS) and intensive care unit (ICU) stay duration were also recorded. Serum chloride levels were measured upon admission and within 24 hours post-surgery. Image analysis of body composition Preoperative non-contrast abdominal CT images were analyzed to assess body composition parameters. Two trained urologists, blinded to patient outcomes, conducted the image analyses using the ARIA Oncology Information System (Varian medical system, Inc., CA, USA), under the supervision of a certified radiologist. The regions of interest included the psoas, axial, skeletal muscles, and visceral fat. These areas were manually outlined on axial CT images at the L3 vertebral level. The software automatically calculated muscle area (in cm 2 ) and muscle density (in Hounsfield units, HU). Sarcopenia was assessed by normalizing the muscle area to patient height (cm 2 /m 2 ). Myosteatosis was evaluated by measuring the mean muscle density (HU) at the L3 level. (Figures 1). The outcomes from the two urologists were averaged, and this value was used for further analysis. Novel inflammatory and nutritional serum biomarkers Baseline blood tests collected on the day of admission were used to calculate novel inflammatory and nutritional markers. 1) Neutrophil-to-lymphocyte ratio (NLR) 2) Platelet-to-lymphocyte ratio (PLR) 3) Systemic inflammatory response index (SIRI) (calculated as the product of neutrophils and monocytes, divided by the lymphocyte count) 4) Prognostic nutritional index (PNI) [(10 × serum albumin {g/dL}) + (0.005 × lymphocytes/µL)]. These biomarkers were analyzed as dichotomous variables based on previously reported thresholds for bladder cancer 12,13 . Statistical analysis Statistical analyses were conducted using IBM SPSS Statistics version 29 (IBM Corp, Armonk, NY, USA). Demographic data were presented as mean ± standard deviation for normally distributed variable or median with interquartile range for non-normally distributed variables. Inter-rater reliability for body composition measurements was assessed using intraclass correlation coefficients (ICC). Group comparisons were performed using independent t-tests or Mann–Whitney U tests for continuous variables and chi-square test or Fisher’s exact tests, for categorical variables. Receiver operating characteristic (ROC) curves were constructed for psoas muscle density (PMD), axial muscle density (AMD), and skeletal muscle density (SMD), and their area under the ROC curve (AUC) were calculated. A backward stepwise logistic regression model was employed to identify independent predictors of postoperative complications. Variables with p < 0.2 in univariate analysis were included in the multivariate models. Statistical significance was set at p < 0.05 for all analyses Results Patient demographics are summarized in Table 1 . The median age of the patients was 66.87 years (range: 41-92), and 103 patients were male (81.1%). Among the 127 patients, 51 (40%) received NAT, specifically 18 with dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC), 17 with gemcitabine/cisplatin, 9 with pembrolizumab, and 7 with gemcitabine/carboplatin. Most patients underwent open RC (81.1%), and 82.5% had an ileal conduit urinary diversion. High comorbidity burden (ACC index > 4) was seen in 55.9% of patients. Preoperative anemia (65.4%) and hypoalbuminemia (21.3%) were observed, but no significant differences in perioperative laboratory results between groups were found. None of the patients exhibited hyperchloremia before surgery. However, two patients with postoperative hypochloremia experienced major complications, whereas none of the patient with hyperchloremia experienced such complications. The pathological T stage of the RC specimen was pT0-pT2 in 63 patients (49.60%) and pT3-T4 in 64 patients (50.40%). Pathological lymph node metastasis was observed in 35 patients (27.60%). During the observation period, 39 patients (30.7%) experienced major postoperative complication within 90 days, and 46 patients (36.2%) experienced within 180 days. A total of 10 patients (7.9%) died. The reliability and consistency of body composition measurements were assessed using ICC. Excellent agreement was observed across all measurements: PMD (ICC = 0.914), SMD (ICC = 0.939), AMD (ICC = 0.935), psoas muscle index (PMI) (ICC = 0.980), skeletal muscle index (SMI) (ICC = 0.965) and axial muscle index (AMI) (ICC = 0.987). These results reflect high inter-rater reliability for the image analysis. Table 2 compares imaging parameters between patients who developed 180-day postoperative complications (CDC grades 3-5) and those who did not (CDC grades 0-2). A significant association was observed between low PMD, low SMD, low AMD, and high axial muscle index (AMI) with major complications at 180 days postoperatively. Patients with major complications had a median PMD of 38.84 HU, median SMD of 28.22 HU, median AMD of 33.88 HU, and median AMI of 15.23 cm²/m². By contrast, patients without major complications had a median PMD of 42.09 HU (p = 0.016), median SMD of 31.53 HU (p = 0.021), median AMD of 36.96 HU (p = 0.019), and median AMI of 14.35 cm²/m² (p = 0.043). This prompted an evaluation of the predictive value of PMD, SMD, AMD, and AMI for major complications using ROC curves. PMD had an AUC of 0.629, with an optimal cutoff of 43.5 HU (78.3% sensitivity and 51.85% specificity). Similar analyses revealed an AUC of 0.692 for SMD (cutoff: 32.5 HU, 69.6% sensitivity, 56.79% specificity), an AUC of 0.618 for AMD (cutoff: 37.2 HU, 60.9% sensitivity, 61.73% specificity), and an AUC of 0.579 for AMI (cutoff: 15 cm²/m², 52.2% sensitivity, 60.5% specificity). (See Figure 2 : ROC curve demonstrating the myosteatosis cutoff point.) Table 3 presents the multivariate analysis of factors associated with 180-day major postoperative complications. Patients with PMD ≤ 43.5 HU had a significantly higher likelihood of complications (adjusted OR 3.959, p = 0.002), as did patients with SMD ≤ 32.5 HU (adjusted OR 3.004, p = 0.005) and AMD ≤ 37.2 HU (adjusted OR 2.644, p = 0.010). Additionally, patients with AMI of ≥ 15 cm²/m² showed a trend toward increased risk (adjusted OR 2.088, p = 0.071). Postoperative serum chloride levels were inversely associated with complications (adjusted OR 0.985, p = 0.017), suggesting that higher chloride levels reduced the risk of complications. Other factors, including gender, age, BMI, preoperative chronic kidney disease (CKD), hypoalbuminemia, and thrombocytopenia, were not significantly associated with complications. Table 4 presents the characteristics of patients with and without myosteatosis, defined by PMD ≤ 43.5 HU. Patients with myosteatosis were more likely to have an ACC index > 4 (65.3% vs. 42.3%, p = 0.01) and were significantly older (mean age: 69.32 years vs. 63.35 years, p < 0.001). Notably, all patients over the age of 80 had myosteatosis. Additionally, patients with myosteatosis had significant lower preoperative serum chloride levels (100.75 ± 3.23 vs 102 ± 3.41, p = 0.011) and a higher incidence of anemia (73.3% vs. 53.8%, p = 0.023). No significant differences in BMI, diabetes mellitus, or coronary artery disease were observed between the two groups. According to multivariate analysis, older age (p = 0.001) and anemia (p = 0.018) were significantly associated with myosteatosis. (See Table 5 ) Discussion This study evaluated body composition parameters, particularly myosteatosis, and perioperative serum chloride levels as predictors of major complications following RC for MIBC. Our results indicate that myosteatosis, defined by low PMD, and serum chloride levels within the first 24 hours post-surgery are significant independent predictors of major complications at 180 days postoperatively. Myosteatosis has been associated with poor postoperative outcomes in various oncologic surgeries, including gastric, colorectal, and pancreatic surgeries 9 , 10 , 21 – 23 . However, its role in bladder cancer has been less explored. In this study, we measured PMD, SMD, and AMD through preoperative CT scans at the L3 vertebral level. Our findings suggest that PMD is a particularly practical and reliable marker for identifying high-risk patients. While SMD and AMD also demonstrated predictive value, PMD exhibited the strongest association with major postoperative complications. This finding aligns with the study by Yamashita et al., which reported that low psoas density (< 44 HU) was associated with poorer 2-year cancer-specific survival in patients undergoing RC 21 , 22 . However, further exploration is needed to determine appropriate cutoff points and the optimal area for measuring fat infiltration, as most previous studies on bladder cancer have used SMD as a representative of myosteatosis 21 , 22 , 24 . The mechanisms by which myosteatosis impacts postoperative complications remain speculative. It is thought to impair insulin sensitivity and contribute to systemic inflammation, both of which negatively affect wound healing and immune responses 25 – 28 . In our cohort, myosteatosis was associated with older age and a higher incidence of anemia, which may contribute to decreased resilience against major surgery. Notably, all patients over the age of 80 exhibited myosteatosis, consistent with previous findings that linked ectopic fat accumulation in muscles with aging 29 . Anderson et al. demonstrated that fat accumulations in paraspinal muscles is more significant than in the psoas muscle 30 . Interestingly, the association between anemia and myosteatosis has not been widely reported. A recent study by De La Cruz-Gongora et al. showed that anemia is significantly associated with incident and persistent sarcopenia. 31 Moreover, low hemoglobin caused by iron deficiency has been linked to reduced muscle mass, as measured by 24-hours urinary creatinine excretion rates 32 . Further research is needed to fully understand the causes of myosteatosis and potential preventive measures for postoperative complications in patients with existing myosteatosis. While sarcopenia has been associated with poorer survival outcomes following RC 6 , 7 , 33 – 36 , none of the skeletal muscle indices, including SMI, PMI, or AMI, were significantly associated with major complications in our study. Interestingly, AMI exhibited a trend toward higher values in patients with major complications, although it did not reach statistical significance. Hillers et al. recently demonstrated that while increased SMI was associated with improved overall survival in patients with localized renal cell carcinoma, it also increased the risk of complications within 90 days post-surgery 37 . This suggests that sarcopenia’s role in postoperative complications and cancer survival warrants further study. Our findings suggest that factors beyond sarcopenia—such as myosteatosis, comorbidities, and obesity—may play a more substantial role in influencing surgical complications. The role of postoperative serum chloride levels remains contentious. Our study found that immediate postoperative chloride levels were associated with major postoperative complications. Veerakulwatana et al. previously demonstrated that hypochloremia within 24 hours post-surgery was a risk factor for postoperative complications 38 . Similarly, Kimura et al. reported that hypochloremia within 48 hours was independently associated with increased hospital mortality following thoracic and abdominal surgery in patients requiring postoperative intensive care 20 . However, Semler et al. showed that replacing normal saline with balanced crystalloid solutions was linked to a lower incidence of death, new renal-replacement therapy, or persistent renal dysfunction in critically ill adults 16 . While the protective effect of hyperchloremia in the perioperative period following RC requires further exploration, our study reinforces the importance of careful monitoring of chloride levels during perioperative care. The choice of intravenous fluid management, particularly between normal saline and balanced crystalloid solutions, may influence postoperative risk mitigation. This study has several limitations. The retrospective design and single-center setting may introduce selection and assessment biases. Moreover, the study cohort consisted entirely of Thai patients, which may limit the generalizability of our findings to other ethnic populations. Additionally, as the creation of cutoff points generates data-driven results, our findings require validation in independent samples to confirm their broader applicability. Conclusion This study highlights the significance of myosteatosis and immediate postoperative serum chloride levels as independent predictors of major complications within 180 days following RC for MIBC. Incorporating body composition analysis and early perioperative serum chloride monitoring into the evaluation process may improve the identification of high-risk patients and allow for more personalized surgical and postoperative care. While sarcopenia is a well-established predictor of poor surgical outcomes, our findings suggest that myosteatosis may serve as a stronger and more reliable indicator of adverse outcomes in bladder cancer patients undergoing RC. Declarations Acknowledgement The authors would like to express gratitude to Miss Jitsiri Chaiyatho and Miss Nerisa Thornsri for their valuable contributions to this study. Conflicts of Interest The authors have no conflicts of interest to declare. Author contributions Wassapol Sornthai: Writing – original draft, Formal analysis, Data curation. Achiraya Teyateeti: Conceptualization, Resources, Data Resources curation. Tawatchai Taweemonkongsap: Resources, Siros Jitpraphai: Resources, Varat Woranisarakul: Resources, Kantima Jongitaree: Resources, Katunyou Mahamongkol: Resources, Data Resources curation, Nattaporn Wanvimolkul: Resources, Data Resources curation, Thitipat Hansomwong: Writing – review & editing, Project administration, Methodology, Conceptualization. Data availibility statement The data from this study are not deposited in a publicly accessible repository. However, the data will be made available upon request for academic purposes. Please contact T.H. 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Heliyon 10 , e33476 (2024). https://doi.org/10.1016/j.heliyon.2024.e33476 Tables Table 1 : Demographic Characteristics of the Study Population Demographic factor CDC 0-2 CDC 3-5 Total P value N (% of 81) N (% of 46) N (% of 127) Gender Male 63 (77.8) 40 (87) 103 (81.1) 0.765 ACC index > 4 43 (53.1) 28 (60.9) 71 (55.9) 0.081 Age* 66.83 ± 9.02 66.96 ± 9.02 66.87 ± 8.98 0.938 BMI (kg/m 2 )* 23.75 ± 4.80 23.99 ± 4.16 23.84 ± 4.56 0.780 BMI <18.4 kg/m 2 15 (18.5) 4 (8.7) 19 (15) 0.613 18.5-29.9 kg/m 2 61 (75.3) 38 (82.6) 99 (78) ≥ 30 kg/m 2 5 (6.2) 4 (8.7) 9 (7.1) ASA ASA 1 18 (17.1) 4 (18.2) 22 (17.3) 0.236 ASA 2 43 (41) 4 (18.2) 47 (37) ASA 3 44 (41.9) 14 (63.6) 58 (45.7) Neoadjuvant treatment 32 (39) 19 (41.3) 51 (40) 0.380 Diversion Ileal conduit 71 (87.7) 35 (76.1) 106 (82.5) 0.198 Neobladder 6 (7.4) 4 (8.7) 10 (7.9) Ureterostomy 4 (4.9) 7 (15.2) 11 (8.7) Laboratory result NLR* 3.50 ± 3.27 4.90 ± 9.12 4.01 ± 6.08 0.162 PLR* 169.80 ± 109.03 169.39 ± 116.38 169.65 ± 111.29 0.940 SIRI* 3.03 ± 8.43 3.24 ± 5.14 3.11 ± 7.39 0.099 PNI* 48.74 ± 7.18 47.44 ± 8.12 48.27 ± 7.53 0.865 a CKD stage ≥ 3 40 (49.4) 27 (58.7) 67 (52.8) 0.312 Hemoglobin (g/dl)* 11.55 ± 1.86 11.08 ± 1.75 11.38 ± 1.83 0.077 b Anemia 49 (60.5) 34 (73.9) 83 (65.4) 0.127 Platelet count (/ul)* 288,876 ± 127,443 267,173 ± 96,346 281,015 ± 117,205 0.635 c Thrombocytopenia 3 (3.7) 5 (10.9) 8 (6.3) 0.137 Serum albumin (g/dl)* 3.82 ± 0.56 3.88 ± 0.69 3.84 ± 0.61 0.253 d Hypoalbuminemia 16 (19.8) 11 (23.9) 27 (21.3) 0.582 Pre-operative serum chloride <98 11 (13.6) 7 (15.2) 18 (14.2) 0.084 98-110 70 (86.4) 39 (84.8) 109 (85.8) Post-operative serum chloride 110 6 (7.4) 0 (0) 6 (4.7) CDC, Clavien dindo classification; ACC index, Age-adjusted Charlson comorbidity index; BMI, Body mass index; ASA, American Society of Anesthesiologists; CMT, chemotherapy; NLR, Neutrophil-to-lymphocyte ratio; PLR, Platelet-to-lymphocyte ratio; SIRI, Systemic inflammation response index; PNI, Prognostic nutritional index; CKD, chronic kidney disease a CKD stage ≥3 is GFR < 60 mL/min/1.73 m 2 ; b Anemia is serum hemoglobin < 12 g/dl; c Thrombocytopenia is platelet count < 150,000/μL; d Hypoalbuminemia is serum albumin < 3g/dl *Mean ± SD Table 2 : Comparison of Imaging Parameter Between Patients with 180-day Postoperative Complications (CDC 0-2 vs. CDC 3-5) CDC 0-2 CDC 3-5 Total P value (N=81) (N=46) (N=127) PMD (HU) 43.09 40.86 42.91 0.016 (36.70 - 47.12) (35.45 – 52.85) (35.45 – 52.85) SMD (HU) 33.29 29.7 31.87 0.021 (25.88 – 37.72) (23.76 – 34.40) (23.76 – 37.72) AMD (HU) 39.16 35.47 38 0.019 (32.66 – 44.11) (29.29 – 41.02) (29.29 – 44.11) VFD (HU) -80.77 -77.48 -81.34 0.725 (-90.09 - -68.45) (-91.81 - -70.72) (-91.81 – 70.72) PMI (cm 2 /m 2 ) 2.49 2.68 2.57 0.099 (0.49 – 8.46) (0.94 – 5.18 ) ( 0.49 – 8.46 ) SMI (cm 2 /m 2 ) 21.65 23.96 22.05 0.228 (9.33 – 44.79) (12.30 – 39.31) (9.33 – 44.79) AMI (cm 2 /m 2 ) 14.35 15.23 14.64 0.043 (5.29 – 27.59) (7.44 – 25.35) (5.29 – 27.59) VFI (cm 2 /m 2 ) 20.88 19.71 20.23 0.588 (1.56 – 93.28) (1.22 – 60.57) (1.22 – 93.28) CDC, Clavien dindo classification ; PMD, Psoas muscle density; SMD, Skeletal muscle density; AMD, Axial muscle density; VFD, viceral fat density; PMI, Psoas muscle index;; SMI, Skeletal muscle index;; AMI, axial muscle index; VFI, visceral fat index Table 3 : Factors Associated with 180-day Postoperative Complications Complication 180 days Univariate Multivariate Crude OR 95% CI P value Adjusted OR 95% CI P value PMD ≤ 43.5 HU 3.877 1.699-8.848 0.001 3.959 1.654-9.480 0.002 SMD ≤ 32.5 HU 3.004 1.396-6.466 0.005 AMD ≤ 37.2 HU 2.644 1.256-5.566 0.010 VFD 0.997 0.980-1.013 0.678 PMI 1.155 0.866-1.542 0.327 SMI 1.040 0.984-1.099 0.164 AMI ≥ 15 cm 2 /m 2 1.823 0.877-3.788 0.108 2.088 0.938-4.646 0.071 VFI 0.989 0.971-1.008 0.267 Gender male 1.905 0.697-5.205 0.209 Age > 80 1.190 0.318-4.458 0.796 ACC index > 4 1.375 0.659-2.868 0.396 Neoadjuvant treatment 0.647 0.243-1.719 0.382 Diversion Conduit 1.000 Neobladder 1.352 0.358-5.105 0.656 Ureterostomy 3.550 0.974-12.941 0.055 BMI 4.1 1.100 0.467-2.590 0.827 PLR > 164.7 1.128 0.525-2.425 0.757 SIRI > 2.35 1.531 0.676-3.469 0.307 PNI < 45 1.382 0.626-3.052 0.423 a Anemia 1.850 0.836-4.096 0.129 Pre-op Cl level 0.967 0.869-1.077 0.546 Post-op Cl level 0.846 0.751-0.953 0.006 0.985 0.759-0.973 0.017 b CKD stage ≥ 3 1.457 0.701-3.025 0.313 c Hypoalbuminemia 0.976 0.306-3.108 0.967 d Thrombocytopenia 1.500 0.175-12.847 0.711 PMD, Psoas muscle density; SMD, Skeletal muscle density; AMD, Axial muscle density; VFD, viceral fat density; PMI, Psoas muscle index; SMI, Skeletal muscle index; AMI, axial muscle index; VFI, visceral fat index. HU, Hounsfield unit; BMI, body mass index; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; PNI, prognostic nutritional index; Pre-op Cl level, pre-operative chloride level; Post-op Cl level, post-operative chloride level; ACC index, age-adjusted Charlson comorbidity index; CKD, chronic kidney disease; CMT, chemotherapy a Anemia is serum hemoglobin < 12g/dl; b CKD stage ≥3 is GFR < 60 mL/min/1.73 m2; c Hypoalbuminemia is serum albumin < 3g/dl; d Thrombocytopenia is platelet count < 150,000/μL Table 4 : Characteristics of Patients with Myosteatosis Character of myosteatosis No Myosteatosis Myosteatosis P value N (% of 52) N (% of 75) Gender Male 45 (86.5) 58 (77.3) 0.193 ACC index > 4 22 (42.3) 49 (65.3) 0.010 Age* 63.35 ± 9.50 69.32 ± 7.77 <0.001 Age ≥ 80 0 (0) 10 (13.3) 0.005 BMI (kg/m 2 )* 23.48 ± 4.55 24.08 ± 4.59 0.461 Diabetes mellitus 6 (11.5) 18 (24) 0.078 Hypertension 25 (48.1) 44 (58.7) 0.239 Hyperlipidemia 15 (28.8) 33 (44) 0.083 Cerebrovascular disease 2 (3.8) 3 (4) 0.965 Coronary artery disease 6 (11.5) 9 (12) 0.937 PMI (cm 2 /m 2 )* 2.8 ± 1.39 2.75 ± 1.15 0.868 SMI (cm 2 /m 2 )* 23.03 ± 7.07 23.04 ± 6.35 0.810 AMI (cm 2 /m 2 )* 14.46 ± 4.51 14.77 ± 4.08 0.657 VFI (cm 2 /m 2 )* 26.74 ± 21.87 25.62 ± 18.58 0.887 Laboratory result Pre-operative serum chloride (mmol/l)* 102 ± 3.41 100.75 ± 3.23 0.011 Pre-operative serum chloride 98-110 47 (90.4) 62 (82.7) 0.220 <98 1 (1.9) 1 (1.3) Hemoglobin* 11.68 ± 1.83 11.17 ± 1.81 0.071 a Anemia 28 (53.8) 55 (73.3) 0.023 Serum albumin (g/dl)* 3.81 ± 0.63 3.86 ±0.60 0.653 b Hypoalbuminemia 6 (11.5) 8 (10.7) 0.877 Platelet count* 273,653 ± 101,861 286,120 ± 127,180 0.739 c Thrombocytopenia 2 (3.8) 6 (8) 0.470 d CKD stage ≥ 3 24 (46.2) 43 (57.3) 0.215 NLR (cm 2 /m 2 )* 3.24 ± 2.59 4.54 ± 7.59 0.192 PLR (cm 2 /m 2 )* 155.21 ± 80.85 179.67 ± 127.81 0.424 SIRI (cm 2 /m 2 )* 2.51 ± 7.65 3.52 ± 7.23 0.462 PNI (cm 2 /m 2 )* 49.31 ± 49.31 47.55 ± 8.32 0.286 ACC index, Age-adjusted Charlson comorbidity index; BMI, Body mass index; PMI, Psoas muscle index; SMI, Skeletal muscle index;; AMI, axial muscle index; VFI, visceral fat index; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; PNI, prognostic nutritional index; CKD, chronic kidney disease a Anemia is serum hemoglobin < 12g/dl; b Hypoalbuminemia is serum albumin < 3g/dl; c Thrombocytopenia is platelet count < 150,000/μL; d CKD stage ≥3 is GFR < 60 mL/min/1.73 m2 *Mean ± SD Table 5 : Risk factors for Myosteatosis Risk factor Myosteatosis Univariate Multivariate Crude OR 95% CI P value Adjusted OR 95% CI P value Gender Male 0.531 0.203-1.390 0.193 ACC index > 4 2.570 1.242-5.318 0.010 Age 1.087 1.037-1.138 <0.001 1.090 1.037-1.145 0.001 BMI (kg/m 2 ) 1.030 0.952-1.115 0.461 Diabetes mellitus 2.241 0.889-6.596 0.078 Hypertension 1.533 0.752-3.125 0.239 Hyperlipidemia 1.938 0.912-4.117 0.083 Cerebrovascular disease 0.960 0.155-5.956 0.965 Coronary artery disease 1.045 0.348-3.139 0.937 PMI (cm 2 /m 2 ) 0.969 0.730-1.286 0.868 SMI (cm 2 /m 2 ) 1.000 0.948-1.055 0.810 AMI (cm 2 /m 2 ) 1.018 0.936-1.107 0.657 VFI (cm 2 /m 2 ) 0.997 0.980-1.015 0.887 Laboratory result Pre-operative serum chloride (mmol/l) 0.887 0.790-0.995 0.011 0.906 0.800-1.077 0.123 Pre-operative serum chloride 98-110 1.971 0.657-5.914 0.220 <98 Hemoglobin 0.854 0.700-1.041 0.071 a Anemia 2.357 1.116-4.979 0.023 2.691 1.188-6.098 0.018 Serum albumin (g/dl) 1.147 0.641-2.053 0.653 b Hypoalbuminemia 0.833 0.353-1.965 0.877 c Thrombocytopenia 2.174 0.471-11.220 0.470 d CKD stage ≥ 3 1.568 0.769-3.194 0.215 NLR (cm 2 /m 2 ) 1.062 0.953-1.183 0.192 PLR (cm 2 /m 2 ) 1.002 0.999-1.006 0.424 SIRI (cm 2 /m 2 ) 1.022 0.965-1.082 0.462 PNI (cm 2 /m 2 ) 0.968 0.922-1.017 0.286 ACC index, Age-adjusted Charlson comorbidity index; BMI, Body mass index; PMI, Psoas muscle index; SMI, Skeletal muscle index;; AMI, axial muscle index; VFI, visceral fat index; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; PNI, prognostic nutritional index; CKD, chronic kidney disease a Anemia is serum hemoglobin < 12g/dl; b Hypoalbuminemia is serum albumin < 3g/dl; c Thrombocytopenia is platelet count < 150,000/μL; d CKD stage ≥3 is GFR < 60 mL/min/1.73 m2 Additional Declarations No competing interests reported. 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University","correspondingAuthor":false,"prefix":"","firstName":"NATTAPORN","middleName":"","lastName":"WANVIMOLKUL","suffix":""}],"badges":[],"createdAt":"2024-10-11 06:38:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5243839/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5243839/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-025-87655-8","type":"published","date":"2025-01-25T15:58:26+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":71938247,"identity":"c97fe1ac-b703-412c-8cbb-a0ecf3fcd78e","added_by":"auto","created_at":"2024-12-20 00:51:55","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1275335,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"Figure1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-5243839/v1/c5c4adce5ac1fca2d027e088.jpeg"},{"id":71938246,"identity":"464a7f86-37ea-4aab-97b9-ea563e35cb28","added_by":"auto","created_at":"2024-12-20 00:51:55","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":119648,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"Figure2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-5243839/v1/b4c2d70b2fcc2866bc7f24af.jpeg"},{"id":74858658,"identity":"8c2c43c8-c936-43c5-b973-1e0b759e4fac","added_by":"auto","created_at":"2025-01-27 16:12:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2768640,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5243839/v1/c3ff5931-ecbf-4aa9-9f55-85f48e2b6b84.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Preoperative Myosteatosis and Perioperative Serum Chloride Levels: Independent Predictors of 180-Day Complications After Radical Cystectomy","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBladder cancer is the 10th most commonly diagnosed cancer globally and the 13th leading cause of cancer-related mortality\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Muscle-invasive bladder cancer (MIBC) presents significant challenges due to its aggressive nature, with about 25% of patients either presenting with or progressing to this advanced stage\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Radical cystectomy (RC) remains the standard treatment for patients with MIBC, involving complete bladder removal and creation of either an external urinary diversion or a continent urinary reservoir. Despite its curative potential, RC is associated with substantial postoperative complications, with morbidity and mortality rates ranging between 40\u0026ndash;75%, particularly in older individuals\u003csup\u003e\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSeveral studies have highlighted the importance of identifying risk factors to tailor treatment strategies for these patients. Sarcopenia, characterized by reduced muscle mass has been shown to predict poor cancer prognosis and survival\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. However, emerging evidence suggests that muscle quality, particularly myosteatosis (fat infiltration into skeletal muscle), may be an even stronger predictor of adverse surgical outcomes. Myosteatosis has been associated with poorer survival in several cancers, though its role in bladder cancer remains underexplored\u003csup\u003e\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn addition to body composition, novel serum biomarkers representing inflammatory and nutritional status\u0026mdash;such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), and prognostic nutritional index (PNI) \u0026mdash; have gained attention as potential predictors of postoperative complications\u003csup\u003e\u003cspan additionalcitationids=\"CR12 CR13 CR14\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. Among these, serum chloride levels have emerged as significant perioperative markers, with studies suggesting that both hypo- and hyperchloremia can affect surgical outcomes\u003csup\u003e\u003cspan additionalcitationids=\"CR17 CR18 CR19\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. Combining these serum markers with imaging biomarkers like sarcopenia and myosteatosis could offer a more comprehensive preoperative risk stratification approach for MIBC patients.\u003c/p\u003e \u003cp\u003eGiven that preoperative CT scans and serum biomarkers analyses are routinely used for MIBC patients, incorporating these novel predictors into preoperative evaluation can enhance risk assessment. This study aims to assess the predictive value of preoperative sarcopenia, myosteatosis, along with novel serum biomarkers in forecasting major complications using standardized reporting methods. Understanding these relationships could lead to improved patient counseling and personalized prehabilitation strategies, ultimately reducing postoperative complications.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design and patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis retrospective, single-center cohort study was conducted at Siriraj Hospital, Mahidol University, Bangkok, Thailand, over a 10-year period (January 2013 to June 2023). The study included 127 patients with MIBC who underwent RC. Patients receiving neo-adjuvant cisplatin-based chemotherapy or immune-oncology (IO) treatments were also included. Exclusions criteria comprised patients lacking a preoperative abdominal CT scan within 60 days of surgery, those diagnosed with non-urothelial cancers, patients receiving adjuvant chemotherapy, IO, or radiation within 180 days postoperatively, and those lost to follow-up before the 180-day postoperative period. Routine follow-ups were conducted at 1, 3, and 6 months post-surgery. This study was approved by the Siriraj institutional Review Board. (SIRB 828/2565(IRB1)).\u0026nbsp;Due to the retrospective nature of the study, the Siriraj institutional Review Board waived the need of obtaining informed consent.\u0026nbsp;All methods in this study were conducted in compliance with the relevant guidelines and regulations outlined by\u0026nbsp;Scientific Reports.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDemographic and clinical data were retrieved from medical records, including gender, age at surgery, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, age-adjusted Charlson comorbidity index (ACC index), neoadjuvant treatment (NAT) status, surgical approach (open, laparoscopic or robotic), and type of urinary diversion (cutaneous ureterostomy, ileal conduit, or neobladder). Postoperative complications were categorized using the Clavien-Dindo classification (CDC), with major complications defined as grade 3 or higher. Length of hospital stay (LOS) and intensive care unit (ICU) stay duration were also recorded. Serum chloride levels were measured upon admission and within 24 hours post-surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImage analysis of body composition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePreoperative non-contrast abdominal CT images were analyzed to assess body composition parameters. Two trained urologists, blinded to patient outcomes, conducted the image analyses using the ARIA Oncology Information System (Varian medical system, Inc., CA, USA), under the supervision of a certified radiologist. The regions of interest included the psoas, axial, skeletal muscles, and visceral fat. These areas were manually outlined on axial CT images at the L3 vertebral level. The software automatically calculated muscle area (in cm\u003csup\u003e2\u003c/sup\u003e) and muscle density (in Hounsfield units, HU). Sarcopenia was assessed by normalizing the muscle area to patient height (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e). Myosteatosis was evaluated by measuring the mean muscle density (HU) at the L3 level. (Figures 1). The outcomes from the two urologists were averaged, and this value was used for further analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNovel inflammatory and nutritional serum biomarkers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBaseline blood tests collected on the day of admission were used to calculate novel inflammatory and nutritional markers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1) Neutrophil-to-lymphocyte ratio (NLR)\u003c/p\u003e\n\u003cp\u003e2) Platelet-to-lymphocyte ratio (PLR)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;3) Systemic inflammatory response index (SIRI) (calculated as the product of neutrophils and monocytes, divided by the lymphocyte count)\u003c/p\u003e\n\u003cp\u003e4) Prognostic nutritional index (PNI) [(10 \u0026times; serum albumin {g/dL}) + (0.005 \u0026times; lymphocytes/\u0026micro;L)].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThese biomarkers were analyzed as dichotomous variables based on previously reported thresholds for bladder cancer\u003csup\u003e12,13\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analyses were conducted using IBM SPSS Statistics version 29 (IBM Corp, Armonk, NY, USA). Demographic data were presented as mean \u0026plusmn; standard deviation for normally distributed variable or median with interquartile range for non-normally distributed variables. Inter-rater reliability for body composition measurements was assessed using intraclass correlation coefficients (ICC). Group comparisons were performed using independent t-tests or Mann\u0026ndash;Whitney U tests for continuous variables and chi-square test or Fisher\u0026rsquo;s exact tests, for categorical variables. Receiver operating characteristic (ROC) curves were constructed for psoas muscle density (PMD), axial muscle density (AMD), and skeletal muscle density (SMD), and their area under the ROC curve (AUC) were calculated. A backward stepwise logistic regression model was employed to identify independent predictors of postoperative complications. Variables with p \u0026lt; 0.2 in univariate analysis were included in the multivariate models. Statistical significance was set at p \u0026lt; 0.05 for all analyses\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003ePatient demographics are summarized in \u003cstrong\u003eTable 1\u003c/strong\u003e. The median age of the patients was 66.87 years (range: 41-92), and 103 patients were male (81.1%). Among the 127 patients, 51 (40%) received NAT, specifically 18 with dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC), 17 with gemcitabine/cisplatin, 9 with pembrolizumab, and 7 with gemcitabine/carboplatin. Most patients underwent open RC (81.1%), and 82.5% had an ileal conduit urinary diversion. High comorbidity burden (ACC index \u0026gt; 4) was seen in 55.9% of patients. Preoperative anemia (65.4%) and hypoalbuminemia (21.3%) were observed, but no significant differences in perioperative laboratory results between groups were found. None of the patients exhibited hyperchloremia before surgery. However, two patients with postoperative hypochloremia experienced major complications, whereas none of the patient with hyperchloremia experienced such complications. \u003c/p\u003e\n\u003cp\u003eThe pathological T stage of the RC specimen was pT0-pT2 in 63 patients (49.60%) and pT3-T4 in 64 patients (50.40%). Pathological lymph node metastasis was observed in 35 patients (27.60%). During the observation period, 39 patients (30.7%) experienced major postoperative complication within 90 days, and 46 patients (36.2%) experienced within 180 days. A total of 10 patients (7.9%) died. \u003c/p\u003e\n\u003cp\u003eThe reliability and consistency of body composition measurements were assessed using ICC. Excellent agreement was observed across all measurements: PMD (ICC = 0.914), SMD (ICC = 0.939), AMD (ICC = 0.935), psoas muscle index (PMI) (ICC = 0.980), skeletal muscle index (SMI) (ICC = 0.965) and axial muscle index (AMI) (ICC = 0.987). These results reflect high inter-rater reliability for the image analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e Table 2\u003c/strong\u003e compares imaging parameters between patients who developed 180-day postoperative complications (CDC grades 3-5) and those who did not (CDC grades 0-2). A significant association was observed between low PMD, low SMD, low AMD, and high axial muscle index (AMI) with major complications at 180 days postoperatively. Patients with major complications had a median PMD of 38.84 HU, median SMD of 28.22 HU, median AMD of 33.88 HU, and median AMI of 15.23 cm\u0026sup2;/m\u0026sup2;. By contrast, patients without major complications had a median PMD of 42.09 HU (p = 0.016), median SMD of 31.53 HU (p = 0.021), median AMD of 36.96 HU (p = 0.019), and median AMI of 14.35 cm\u0026sup2;/m\u0026sup2; (p = 0.043). This prompted an evaluation of the predictive value of PMD, SMD, AMD, and AMI for major complications using ROC curves. PMD had an AUC of 0.629, with an optimal cutoff of 43.5 HU (78.3% sensitivity and 51.85% specificity). Similar analyses revealed an AUC of 0.692 for SMD (cutoff: 32.5 HU, 69.6% sensitivity, 56.79% specificity), an AUC of 0.618 for AMD (cutoff: 37.2 HU, 60.9% sensitivity, 61.73% specificity), and an AUC of 0.579 for AMI (cutoff: 15 cm\u0026sup2;/m\u0026sup2;, 52.2% sensitivity, 60.5% specificity). \u003cem\u003e(See \u003cstrong\u003eFigure 2\u003c/strong\u003e: ROC curve demonstrating the myosteatosis cutoff point.)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e presents the multivariate analysis of factors associated with 180-day major postoperative complications. Patients with PMD \u0026le; 43.5 HU had a significantly higher likelihood of complications (adjusted OR 3.959, p = 0.002), as did patients with SMD \u0026le; 32.5 HU (adjusted OR 3.004, p = 0.005) and AMD \u0026le; 37.2 HU (adjusted OR 2.644, p = 0.010). Additionally, patients with AMI of \u0026ge; 15 cm\u0026sup2;/m\u0026sup2; showed a trend toward increased risk (adjusted OR 2.088, p = 0.071). Postoperative serum chloride levels were inversely associated with complications (adjusted OR 0.985, p = 0.017), suggesting that higher chloride levels reduced the risk of complications. Other factors, including gender, age, BMI, preoperative chronic kidney disease (CKD), hypoalbuminemia, and thrombocytopenia, were not significantly associated with complications. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e presents the characteristics of patients with and without myosteatosis, defined by PMD \u0026le; 43.5 HU. Patients with myosteatosis were more likely to have an ACC index \u0026gt; 4 (65.3% vs. 42.3%, p = 0.01) and were significantly older (mean age: 69.32 years vs. 63.35 years, p \u0026lt; 0.001). Notably, all patients over the age of 80 had myosteatosis. Additionally, patients with myosteatosis had significant lower preoperative serum chloride levels (100.75 \u0026plusmn; 3.23 vs 102 \u0026plusmn; 3.41, p = 0.011) and a higher incidence of anemia (73.3% vs. 53.8%, p = 0.023). No significant differences in BMI, diabetes mellitus, or coronary artery disease were observed between the two groups. According to multivariate analysis, older age (p = 0.001) and anemia (p = 0.018) were significantly associated with myosteatosis. (See \u003cstrong\u003eTable 5\u003c/strong\u003e)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study evaluated body composition parameters, particularly myosteatosis, and perioperative serum chloride levels as predictors of major complications following RC for MIBC. Our results indicate that myosteatosis, defined by low PMD, and serum chloride levels within the first 24 hours post-surgery are significant independent predictors of major complications at 180 days postoperatively.\u003c/p\u003e \u003cp\u003eMyosteatosis has been associated with poor postoperative outcomes in various oncologic surgeries, including gastric, colorectal, and pancreatic surgeries\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. However, its role in bladder cancer has been less explored. In this study, we measured PMD, SMD, and AMD through preoperative CT scans at the L3 vertebral level. Our findings suggest that PMD is a particularly practical and reliable marker for identifying high-risk patients. While SMD and AMD also demonstrated predictive value, PMD exhibited the strongest association with major postoperative complications. This finding aligns with the study by Yamashita et al., which reported that low psoas density (\u0026lt;\u0026thinsp;44 HU) was associated with poorer 2-year cancer-specific survival in patients undergoing RC\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. However, further exploration is needed to determine appropriate cutoff points and the optimal area for measuring fat infiltration, as most previous studies on bladder cancer have used SMD as a representative of myosteatosis\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe mechanisms by which myosteatosis impacts postoperative complications remain speculative. It is thought to impair insulin sensitivity and contribute to systemic inflammation, both of which negatively affect wound healing and immune responses\u003csup\u003e\u003cspan additionalcitationids=\"CR26 CR27\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. In our cohort, myosteatosis was associated with older age and a higher incidence of anemia, which may contribute to decreased resilience against major surgery. Notably, all patients over the age of 80 exhibited myosteatosis, consistent with previous findings that linked ectopic fat accumulation in muscles with aging\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. Anderson et al. demonstrated that fat accumulations in paraspinal muscles is more significant than in the psoas muscle\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. Interestingly, the association between anemia and myosteatosis has not been widely reported. A recent study by De La Cruz-Gongora et al. showed that anemia is significantly associated with incident and persistent sarcopenia.\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e Moreover, low hemoglobin caused by iron deficiency has been linked to reduced muscle mass, as measured by 24-hours urinary creatinine excretion rates\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. Further research is needed to fully understand the causes of myosteatosis and potential preventive measures for postoperative complications in patients with existing myosteatosis.\u003c/p\u003e \u003cp\u003eWhile sarcopenia has been associated with poorer survival outcomes following RC\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan additionalcitationids=\"CR34 CR35\" citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e, none of the skeletal muscle indices, including SMI, PMI, or AMI, were significantly associated with major complications in our study. Interestingly, AMI exhibited a trend toward higher values in patients with major complications, although it did not reach statistical significance. Hillers et al. recently demonstrated that while increased SMI was associated with improved overall survival in patients with localized renal cell carcinoma, it also increased the risk of complications within 90 days post-surgery\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. This suggests that sarcopenia\u0026rsquo;s role in postoperative complications and cancer survival warrants further study. Our findings suggest that factors beyond sarcopenia\u0026mdash;such as myosteatosis, comorbidities, and obesity\u0026mdash;may play a more substantial role in influencing surgical complications.\u003c/p\u003e \u003cp\u003eThe role of postoperative serum chloride levels remains contentious. Our study found that immediate postoperative chloride levels were associated with major postoperative complications. Veerakulwatana et al. previously demonstrated that hypochloremia within 24 hours post-surgery was a risk factor for postoperative complications\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. Similarly, Kimura et al. reported that hypochloremia within 48 hours was independently associated with increased hospital mortality following thoracic and abdominal surgery in patients requiring postoperative intensive care\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. However, Semler et al. showed that replacing normal saline with balanced crystalloid solutions was linked to a lower incidence of death, new renal-replacement therapy, or persistent renal dysfunction in critically ill adults\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. While the protective effect of hyperchloremia in the perioperative period following RC requires further exploration, our study reinforces the importance of careful monitoring of chloride levels during perioperative care. The choice of intravenous fluid management, particularly between normal saline and balanced crystalloid solutions, may influence postoperative risk mitigation.\u003c/p\u003e \u003cp\u003eThis study has several limitations. The retrospective design and single-center setting may introduce selection and assessment biases. Moreover, the study cohort consisted entirely of Thai patients, which may limit the generalizability of our findings to other ethnic populations. Additionally, as the creation of cutoff points generates data-driven results, our findings require validation in independent samples to confirm their broader applicability.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the significance of myosteatosis and immediate postoperative serum chloride levels as independent predictors of major complications within 180 days following RC for MIBC. Incorporating body composition analysis and early perioperative serum chloride monitoring into the evaluation process may improve the identification of high-risk patients and allow for more personalized surgical and postoperative care. While sarcopenia is a well-established predictor of poor surgical outcomes, our findings suggest that myosteatosis may serve as a stronger and more reliable indicator of adverse outcomes in bladder cancer patients undergoing RC.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express gratitude to Miss Jitsiri Chaiyatho and Miss Nerisa Thornsri for their valuable contributions to this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWassapol Sornthai:\u003c/strong\u003e Writing \u0026ndash; original draft, Formal analysis, Data curation. \u003cstrong\u003eAchiraya Teyateeti:\u003c/strong\u003e Conceptualization, Resources, Data Resources curation. \u003cstrong\u003eTawatchai Taweemonkongsap:\u003c/strong\u003e Resources, \u003cstrong\u003eSiros Jitpraphai:\u0026nbsp;\u003c/strong\u003eResources, \u003cstrong\u003eVarat Woranisarakul:\u0026nbsp;\u003c/strong\u003eResources, \u003cstrong\u003eKantima Jongitaree:\u003c/strong\u003e Resources,\u003cstrong\u003e\u0026nbsp;Katunyou Mahamongkol:\u003c/strong\u003e Resources, Data Resources curation, \u003cstrong\u003eNattaporn Wanvimolkul:\u003c/strong\u003e Resources, Data Resources curation, \u003cstrong\u003eThitipat Hansomwong:\u003c/strong\u003e Writing \u0026ndash; review \u0026amp; editing, Project administration, Methodology, Conceptualization.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availibility statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003c/strong\u003eThe data from this study are not deposited in a publicly accessible repository. However, the data will be made available upon request for academic purposes. Please contact T.H. (the corresponding author) for further details.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSung, H.\u003cem\u003e et al.\u003c/em\u003e Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. \u003cem\u003eCA Cancer J Clin\u003c/em\u003e \u003cstrong\u003e71\u003c/strong\u003e, 209-249 (2021). https://doi.org/10.3322/caac.21660\u003c/li\u003e\n\u003cli\u003eRaghavan, D. 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U.\u003cem\u003e et al.\u003c/em\u003e Body Composition of Patients Undergoing Radical Cystectomy for Bladder Cancer: Sarcopenia, Low Psoas Muscle Index, and Myosteatosis Are Independent Risk Factors for Mortality. \u003cem\u003eCancers (Basel)\u003c/em\u003e \u003cstrong\u003e15\u003c/strong\u003e (2023). https://doi.org/10.3390/cancers15061778\u003c/li\u003e\n\u003cli\u003eO\u0026apos;Sullivan, J., Lysaght, J., Donohoe, C. L. \u0026amp; Reynolds, J. V. Obesity and gastrointestinal cancer: the interrelationship of adipose and tumour microenvironments. \u003cem\u003eNat Rev Gastroenterol Hepatol\u003c/em\u003e \u003cstrong\u003e15\u003c/strong\u003e, 699-714 (2018). https://doi.org/10.1038/s41575-018-0069-7\u003c/li\u003e\n\u003cli\u003eHealy, L. A.\u003cem\u003e et al.\u003c/em\u003e Impact of obesity on outcomes in the management of localized adenocarcinoma of the esophagus and esophagogastric junction. \u003cem\u003eJ Thorac Cardiovasc Surg\u003c/em\u003e \u003cstrong\u003e134\u003c/strong\u003e, 1284-1291 (2007). https://doi.org/10.1016/j.jtcvs.2007.06.037\u003c/li\u003e\n\u003cli\u003eMiljkovic, I.\u003cem\u003e et al.\u003c/em\u003e Abdominal myosteatosis is independently associated with hyperinsulinemia and insulin resistance among older men without diabetes. \u003cem\u003eObesity (Silver Spring)\u003c/em\u003e \u003cstrong\u003e21\u003c/strong\u003e, 2118-2125 (2013). https://doi.org/10.1002/oby.20346\u003c/li\u003e\n\u003cli\u003eShaw, C. S., Clark, J. \u0026amp; Wagenmakers, A. J. The effect of exercise and nutrition on intramuscular fat metabolism and insulin sensitivity. \u003cem\u003eAnnu Rev Nutr\u003c/em\u003e \u003cstrong\u003e30\u003c/strong\u003e, 13-34 (2010). https://doi.org/10.1146/annurev.nutr.012809.104817\u003c/li\u003e\n\u003cli\u003eCorrea-de-Araujo, R.\u003cem\u003e et al.\u003c/em\u003e Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging. \u003cem\u003eFront Physiol\u003c/em\u003e \u003cstrong\u003e11\u003c/strong\u003e, 963 (2020). https://doi.org/10.3389/fphys.2020.00963\u003c/li\u003e\n\u003cli\u003eAnderson, D. E.\u003cem\u003e et al.\u003c/em\u003e Associations of Computed Tomography-Based Trunk Muscle Size and Density With Balance and Falls in Older Adults. \u003cem\u003eJ Gerontol A Biol Sci Med Sci\u003c/em\u003e \u003cstrong\u003e71\u003c/strong\u003e, 811-816 (2016). https://doi.org/10.1093/gerona/glv185\u003c/li\u003e\n\u003cli\u003eDe La Cruz-Gongora, V., Salinas-Rodriguez, A. \u0026amp; Manrique-Espinoza, B. Prospective changes in anemia are associated with the incidence and persistence of sarcopenia among older Mexican adults. \u003cem\u003eFront Nutr\u003c/em\u003e \u003cstrong\u003e11\u003c/strong\u003e, 1323450 (2024). https://doi.org/10.3389/fnut.2024.1323450\u003c/li\u003e\n\u003cli\u003eVinke, J. S. J.\u003cem\u003e et al.\u003c/em\u003e Iron deficiency is related to lower muscle mass in community-dwelling individuals and impairs myoblast proliferation. \u003cem\u003eJ Cachexia Sarcopenia Muscle\u003c/em\u003e \u003cstrong\u003e14\u003c/strong\u003e, 1865-1879 (2023). https://doi.org/10.1002/jcsm.13277\u003c/li\u003e\n\u003cli\u003ePathak, R. A. \u0026amp; Hemal, A. K. Frailty and sarcopenia impact surgical and oncologic outcomes after radical cystectomy in patients with bladder cancer. \u003cem\u003eTransl Androl Urol\u003c/em\u003e \u003cstrong\u003e7\u003c/strong\u003e, S763-S764 (2018). https://doi.org/10.21037/tau.2018.08.06\u003c/li\u003e\n\u003cli\u003eMayr, R.\u003cem\u003e et al.\u003c/em\u003e Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer. \u003cem\u003eJ Cachexia Sarcopenia Muscle\u003c/em\u003e \u003cstrong\u003e9\u003c/strong\u003e, 505-513 (2018). https://doi.org/10.1002/jcsm.12279\u003c/li\u003e\n\u003cli\u003eHirasawa, Y.\u003cem\u003e et al.\u003c/em\u003e Sarcopenia as a Novel Preoperative Prognostic Predictor for Survival in Patients with Bladder Cancer Undergoing Radical Cystectomy. \u003cem\u003eAnn Surg Oncol\u003c/em\u003e \u003cstrong\u003e23\u003c/strong\u003e, 1048-1054 (2016). https://doi.org/10.1245/s10434-016-5606-4\u003c/li\u003e\n\u003cli\u003eLee, S.\u003cem\u003e et al.\u003c/em\u003e Association of preoperative sarcopenia with the long-term prognosis of patients with bladder cancer undergoing radical cystectomy. \u003cem\u003eJ Cancer Res Clin Oncol\u003c/em\u003e \u003cstrong\u003e150\u003c/strong\u003e, 173 (2024). https://doi.org/10.1007/s00432-024-05705-6\u003c/li\u003e\n\u003cli\u003eHillers, A. H., Bach, S. W., Saito, A. \u0026amp; Azawi, N. Muscle matters: Skeletal muscle index and body mass index impact on complications and survival in renal cancer. \u003cem\u003eBJUI Compass\u003c/em\u003e \u003cstrong\u003e5\u003c/strong\u003e, 783-790 (2024). https://doi.org/10.1002/bco2.405\u003c/li\u003e\n\u003cli\u003eVeerakulwatana, S.\u003cem\u003e et al.\u003c/em\u003e Perioperative factors and 30-day major complications following radical cystectomy: A single-center study in Thailand. \u003cem\u003eHeliyon\u003c/em\u003e \u003cstrong\u003e10\u003c/strong\u003e, e33476 (2024). https://doi.org/10.1016/j.heliyon.2024.e33476\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eTable 1 : Demographic Characteristics of the Study Population\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDemographic factor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCDC 0-2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCDC 3-5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (% of 81)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (% of 46)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (% of 127)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e63 (77.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e40 (87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e103 (81.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eACC index \u0026gt; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e43 (53.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e28 (60.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e71 (55.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eAge*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e66.83\u0026nbsp;\u0026plusmn; 9.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e66.96\u0026nbsp;\u0026plusmn; 9.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e66.87\u0026nbsp;\u0026plusmn; 8.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.938\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e23.75\u0026nbsp;\u0026plusmn; 4.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e23.99\u0026nbsp;\u0026plusmn; 4.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e23.84\u0026nbsp;\u0026plusmn; 4.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.780\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026lt;18.4 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e15 (18.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4 (8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e19 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.613\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e18.5-29.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e61 (75.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e38 (82.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e99 (78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026ge;\u0026nbsp;30 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e5 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4 (8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e9 (7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eASA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eASA 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e18 (17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e22 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.236\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eASA 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e43 (41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e47 (37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eASA 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e44 (41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e14 (63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e58 (45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eNeoadjuvant treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e32 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e19 (41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e51 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.380\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eDiversion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eIleal conduit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e71 (87.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e35 (76.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e106 (82.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.198\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eNeobladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e6 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4 (8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e10 (7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eUreterostomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e4 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e7 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e11 (8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eLaboratory result\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eNLR*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e3.50\u0026nbsp;\u0026plusmn; 3.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4.90\u0026nbsp;\u0026plusmn; 9.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e4.01\u0026nbsp;\u0026plusmn; 6.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003ePLR*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e169.80\u0026nbsp;\u0026plusmn; 109.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e169.39\u0026nbsp;\u0026plusmn; 116.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e169.65\u0026nbsp;\u0026plusmn; 111.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.940\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eSIRI*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e3.03\u0026nbsp;\u0026plusmn; 8.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e3.24\u0026nbsp;\u0026plusmn; 5.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e3.11\u0026nbsp;\u0026plusmn; 7.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003ePNI*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e48.74\u0026nbsp;\u0026plusmn; 7.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e47.44\u0026nbsp;\u0026plusmn; 8.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e48.27\u0026nbsp;\u0026plusmn; 7.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.865\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u003csup\u003ea\u003c/sup\u003eCKD stage\u0026nbsp;\u0026ge; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e40 (49.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e27 (58.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e67 (52.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.312\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eHemoglobin (g/dl)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e11.55\u0026nbsp;\u0026plusmn; 1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e11.08\u0026nbsp;\u0026plusmn; 1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e11.38\u0026nbsp;\u0026plusmn; 1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u003csup\u003eb\u003c/sup\u003eAnemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e49 (60.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e34 (73.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e83 (65.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.127\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003ePlatelet count (/ul)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e288,876\u0026nbsp;\u0026plusmn; 127,443\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e267,173\u0026nbsp;\u0026plusmn; 96,346\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e281,015\u0026nbsp;\u0026plusmn; 117,205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.635\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u003csup\u003ec\u003c/sup\u003eThrombocytopenia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e3 (3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e5 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e8 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003eSerum albumin (g/dl)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e3.82\u0026nbsp;\u0026plusmn; 0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e3.88\u0026nbsp;\u0026plusmn; 0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e3.84\u0026nbsp;\u0026plusmn; 0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.253\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u003csup\u003ed\u003c/sup\u003eHypoalbuminemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e16 (19.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e11 (23.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e27 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.582\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003ePre-operative serum chloride\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u0026lt;98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e11 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e7 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e18 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e98-110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e70 (86.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e39 (84.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e109 (85.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003ePost-operative serum chloride\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u0026lt;98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e2 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e0.175\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e98-110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e75 (92.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e44 (95.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e119 (93.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u0026gt;110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e6 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e6 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCDC, Clavien dindo classification; ACC index, Age-adjusted Charlson comorbidity index; BMI, Body mass index; ASA, American Society of Anesthesiologists; CMT, chemotherapy; NLR, Neutrophil-to-lymphocyte ratio; PLR, Platelet-to-lymphocyte ratio; SIRI, Systemic inflammation response index; PNI, Prognostic nutritional index; CKD, chronic kidney disease\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eCKD stage \u0026ge;3 is GFR \u0026lt; 60 mL/min/1.73 m\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e; \u003csup\u003eb\u003c/sup\u003eAnemia is serum hemoglobin \u0026lt; 12 g/dl; \u0026nbsp;\u003csup\u003ec\u003c/sup\u003eThrombocytopenia is platelet count \u0026lt; 150,000/\u0026mu;L;\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003csup\u003ed\u003c/sup\u003eHypoalbuminemia is serum albumin \u0026lt; 3g/dl\u003c/p\u003e\n\u003cp\u003e*Mean \u0026plusmn; SD\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 : Comparison of Imaging Parameter Between Patients with 180-day Postoperative Complications (CDC 0-2 vs. CDC 3-5)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCDC 0-2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; CDC 3-5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Total\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; (N=81)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; (N=46) \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(N=127) \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePMD (HU)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e43.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e40.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e42.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(36.70 \u0026nbsp;- 47.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(35.45 \u0026ndash; 52.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(35.45 \u0026ndash; 52.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSMD (HU)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e33.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e31.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(25.88 \u0026ndash; 37.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(23.76 \u0026ndash; 34.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(23.76 \u0026ndash; 37.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAMD (HU)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e39.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e35.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(32.66 \u0026ndash; 44.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(29.29 \u0026ndash; 41.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(29.29 \u0026ndash; 44.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVFD (HU)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e-80.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e-77.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e-81.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.725\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(-90.09 - -68.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(-91.81 - -70.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(-91.81 \u0026ndash; 70.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e2.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e2.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e2.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(0.49 \u0026ndash; 8.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(0.94 \u0026ndash; 5.18 )\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e( 0.49 \u0026ndash; 8.46 )\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e21.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e23.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e22.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.228\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(9.33 \u0026ndash; 44.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(12.30 \u0026ndash; 39.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(9.33 \u0026ndash; 44.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e14.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e15.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e14.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(5.29 \u0026ndash; 27.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(7.44 \u0026ndash; 25.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(5.29 \u0026ndash; 27.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVFI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e20.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e19.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e20.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e(1.56 \u0026ndash; 93.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e(1.22 \u0026ndash; 60.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;(1.22 \u0026ndash; 93.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCDC, Clavien dindo classification ; PMD, Psoas muscle density; SMD, Skeletal muscle density; AMD, Axial muscle density; VFD, viceral fat density; PMI, Psoas muscle index;; SMI, Skeletal muscle index;; AMI, axial muscle index; VFI, visceral fat index\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eTable 3 : Factors Associated with 180-day Postoperative Complications\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplication 180 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 370px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 296px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003ePMD \u0026le; 43.5 HU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e3.877\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.699-8.848\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e3.959\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e1.654-9.480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eSMD \u0026le; 32.5 HU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e3.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.396-6.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eAMD \u0026le; 37.2 HU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e2.644\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.256-5.566\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eVFD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.980-1.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003ePMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.866-1.542\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eSMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.040\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.984-1.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eAMI \u0026ge; 15 cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.823\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.877-3.788\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e2.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.938-4.646\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eVFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.971-1.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eGender male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.697-5.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eAge \u0026gt; 80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.318-4.458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.796\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eACC index \u0026gt; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.659-2.868\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eNeoadjuvant treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.243-1.719\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.382\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 85px;\"\u003e\n \u003cp\u003eDiversion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eConduit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eNeobladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.358-5.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.656\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eUreterostomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e3.550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.974-12.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 85px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e18.5-29.9 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e2.336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.721-7.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026ge;\u0026nbsp;30\u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e3.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.539-16.689\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eNLR \u0026gt; 4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.467-2.590\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.827\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003ePLR \u0026gt; 164.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.525-2.425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.757\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003eSIRI \u0026gt; 2.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.676-3.469\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003ePNI \u0026lt; 45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.382\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.626-3.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.423\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAnemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.836-4.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003ePre-op Cl level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.869-1.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003ePost-op Cl level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.751-0.953\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e0.985\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.759-0.973\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003csup\u003eb\u003c/sup\u003eCKD stage \u0026ge;\u0026nbsp;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.457\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.701-3.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003csup\u003ec\u003c/sup\u003eHypoalbuminemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e0.976\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.306-3.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003csup\u003ed\u003c/sup\u003eThrombocytopenia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e1.500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.175-12.847\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ePMD, Psoas muscle density; SMD, Skeletal muscle density; AMD, Axial muscle density; VFD, viceral fat density; PMI, Psoas muscle index; SMI, Skeletal muscle index; AMI, axial muscle index; VFI, visceral fat index. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;HU, Hounsfield unit; BMI, body mass index; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; PNI, prognostic nutritional index; Pre-op Cl level, pre-operative chloride level; Post-op Cl level, post-operative chloride level; \u0026nbsp;ACC index, age-adjusted Charlson comorbidity index; CKD, chronic kidney disease; CMT, chemotherapy\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAnemia is serum hemoglobin \u0026lt; 12g/dl; \u003csup\u003eb\u003c/sup\u003eCKD stage \u0026ge;3 is GFR \u0026lt; 60 mL/min/1.73 m2;\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003csup\u003ec\u003c/sup\u003eHypoalbuminemia is serum albumin \u0026lt; 3g/dl; \u003csup\u003ed\u003c/sup\u003eThrombocytopenia is platelet count \u0026lt; 150,000/\u0026mu;L \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 : Characteristics of Patients with Myosteatosis\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacter of myosteatosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo Myosteatosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMyosteatosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (% of 52)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (% of 75)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eGender Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e45 (86.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e58 (77.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eACC index \u0026gt; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e22 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e49 (65.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAge*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e63.35 \u0026plusmn;\u0026nbsp;9.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e69.32 \u0026plusmn; 7.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAge \u0026ge; 80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e10 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e23.48\u0026nbsp;\u0026plusmn; 4.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e24.08\u0026nbsp;\u0026plusmn; 4.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.461\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDiabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e6 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e18 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e25 (48.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e44 (58.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHyperlipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e15 (28.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e33 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eCerebrovascular disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e2 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e3 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.965\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eCoronary artery disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e6 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e9 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.937\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e2.8 \u0026plusmn; 1.39\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2.75\u0026nbsp;\u0026plusmn; 1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.868\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e23.03\u0026nbsp;\u0026plusmn; 7.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e23.04\u0026nbsp;\u0026plusmn; 6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.810\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e14.46\u0026nbsp;\u0026plusmn; 4.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e14.77\u0026nbsp;\u0026plusmn; 4.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.657\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eVFI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e26.74\u0026nbsp;\u0026plusmn; 21.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e25.62\u0026nbsp;\u0026plusmn; 18.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLaboratory result\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePre-operative serum chloride (mmol/l)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e102 \u0026plusmn; 3.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e100.75\u0026nbsp;\u0026plusmn; 3.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003ePre-operative serum chloride\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e98-110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e47 (90.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e62 (82.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026lt;98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e1 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e1 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHemoglobin*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e11.68\u0026nbsp;\u0026plusmn; 1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e11.17\u0026nbsp;\u0026plusmn; 1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAnemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e28 (53.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e55 (73.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSerum albumin (g/dl)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e3.81\u0026nbsp;\u0026plusmn; 0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e3.86\u0026nbsp;\u0026plusmn;0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.653\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003eb\u003c/sup\u003eHypoalbuminemia\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e6 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e8 (10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.877\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePlatelet count*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e273,653\u0026nbsp;\u0026plusmn; 101,861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e286,120\u0026nbsp;\u0026plusmn; 127,180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.739\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003ec\u003c/sup\u003eThrombocytopenia\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e2 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e6 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.470\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003ed\u003c/sup\u003eCKD stage\u0026nbsp;\u0026ge;\u0026nbsp;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e24 (46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e43 (57.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNLR (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e3.24 \u0026plusmn; 2.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e4.54\u0026nbsp;\u0026plusmn; 7.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePLR (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e155.21\u0026nbsp;\u0026plusmn; 80.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e179.67\u0026nbsp;\u0026plusmn; 127.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSIRI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e2.51\u0026nbsp;\u0026plusmn; 7.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e3.52\u0026nbsp;\u0026plusmn; 7.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.462\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePNI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e49.31\u0026nbsp;\u0026plusmn; 49.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e47.55\u0026nbsp;\u0026plusmn; 8.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.286\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eACC index, Age-adjusted Charlson comorbidity index; BMI, Body mass index; PMI, Psoas muscle index; SMI, Skeletal muscle index;; AMI, axial muscle index; VFI, visceral fat index; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; PNI, prognostic nutritional index; CKD, chronic kidney disease\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAnemia is serum hemoglobin \u0026lt; 12g/dl;\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003csup\u003eb\u003c/sup\u003eHypoalbuminemia is serum albumin \u0026lt; 3g/dl; \u003csup\u003ec\u003c/sup\u003eThrombocytopenia is platelet count \u0026lt; 150,000/\u0026mu;L; \u003csup\u003ed\u003c/sup\u003eCKD stage \u0026ge;3 is GFR \u0026lt; 60 mL/min/1.73 m2\u003c/p\u003e\n\u003cp\u003e*Mean \u0026plusmn; SD\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;: Risk factors for Myosteatosis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factor Myosteatosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 310px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eGender Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.203-1.390\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eACC index \u0026gt; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e2.570\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e1.242-5.318\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e1.037-1.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e1.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e1.037-1.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.952-1.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.461\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDiabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e2.241\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.889-6.596\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.752-3.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHyperlipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.938\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.912-4.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eCerebrovascular disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.155-5.956\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eCoronary artery disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.348-3.139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.937\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.730-1.286\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.868\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.948-1.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.810\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eAMI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.936-1.107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.657\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eVFI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.980-1.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLaboratory result\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePre-operative serum chloride (mmol/l)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.790-0.995\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e0.906\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.800-1.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.123\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003ePre-operative serum chloride\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e98-110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.971\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.657-5.914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026lt;98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eHemoglobin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.854\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.700-1.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAnemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e2.357\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e1.116-4.979\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e2.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e1.188-6.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSerum albumin (g/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.641-2.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.653\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003eb\u003c/sup\u003eHypoalbuminemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.353-1.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.877\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003ec\u003c/sup\u003eThrombocytopenia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e2.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.471-11.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.470\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003e\u003csup\u003ed\u003c/sup\u003eCKD stage\u0026nbsp;\u0026ge;\u0026nbsp;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.769-3.194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eNLR (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.953-1.183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePLR (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.999-1.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eSIRI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e1.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.965-1.082\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.462\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003ePNI (cm\u003csup\u003e2\u003c/sup\u003e/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e0.968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0.922-1.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.286\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eACC index, Age-adjusted Charlson comorbidity index; BMI, Body mass index; PMI, Psoas muscle index; SMI, Skeletal muscle index;; AMI, axial muscle index; VFI, visceral fat index; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SIRI, systemic inflammation response index; PNI, prognostic nutritional index; CKD, chronic kidney disease\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eAnemia is serum hemoglobin \u0026lt; 12g/dl;\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003csup\u003eb\u003c/sup\u003eHypoalbuminemia is serum albumin \u0026lt; 3g/dl; \u003csup\u003ec\u003c/sup\u003eThrombocytopenia is platelet count \u0026lt; 150,000/\u0026mu;L; \u003csup\u003ed\u003c/sup\u003eCKD stage \u0026ge;3 is GFR \u0026lt; 60 mL/min/1.73 m2\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"myosteatosis, skeletal muscle, cystectomy, serum chlorides, postoperative complications","lastPublishedDoi":"10.21203/rs.3.rs-5243839/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5243839/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: This study aimed to investigate the role of myosteatosis, sarcopenia, and perioperative serum biomarkers as independent predictors of major complications within 180 days following radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: We retrospectively analyzed of 127 MIBC patients who underwent RC between 2013 and 2023 at a single institution. Preoperative body composition was assessed using CT scans at the L3 vertebral level to measure psoas muscle density (PMD), skeletal muscle density (SMD), axial muscle density (AMD), and muscle indices. Novel inflammatory and nutritional markers, including serum chloride levels within 24 hours post-surgery, were also evaluated. Major complications were defined as Clavien-Dindo grade ≥ 3. Multivariate analysis was performed to identify independent predictors of postoperative complications.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Among the study cohort, 30.7% of patients experienced major complications within 90 days, and 36.2% within 180 days. Myosteatosis (p = 0.002) and postoperative serum chloride levels (p \u0026lt; 0.001) were significant independent predictors of 180-day major complications. Patients with low PMD had an adjusted odds ratio (OR) of 3.959 for developing major complications, while increased serum chloride levels were associated with a reduced risk of complications (OR = 0.985). Multivariate analysis reveals associations between myosteatosis, aging, and anemia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Myosteatosis and perioperative serum chloride levels are significant predictors of major complications after RC for MIBC. Incorporating body composition analysis and early serum chloride monitoring into perioperative care may improve risk stratification and patient outcomes following RC.\u003c/p\u003e","manuscriptTitle":"Preoperative Myosteatosis and Perioperative Serum Chloride Levels: Independent Predictors of 180-Day Complications After Radical Cystectomy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-20 00:51:50","doi":"10.21203/rs.3.rs-5243839/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-27T05:36:49+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-24T12:04:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-16T21:57:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"206816645025706264455340229664134441794","date":"2024-11-08T07:10:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"210175433376965310481347335288725710737","date":"2024-11-06T18:27:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-11-06T18:15:21+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-11-06T18:12:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-10-28T14:10:05+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-28T06:59:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2024-10-11T06:33:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a530bd78-4333-4a71-876e-26c6b4cea9e5","owner":[],"postedDate":"December 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":40813157,"name":"Health sciences/Urology/Bladder"},{"id":40813158,"name":"Health sciences/Risk factors"},{"id":40813159,"name":"Biological sciences/Cancer/Cancer imaging"},{"id":40813160,"name":"Health sciences/Diseases/Urogenital diseases/Urological cancer/Bladder cancer"}],"tags":[],"updatedAt":"2025-01-27T16:07:59+00:00","versionOfRecord":{"articleIdentity":"rs-5243839","link":"https://doi.org/10.1038/s41598-025-87655-8","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2025-01-25 15:58:26","publishedOnDateReadable":"January 25th, 2025"},"versionCreatedAt":"2024-12-20 00:51:50","video":"","vorDoi":"10.1038/s41598-025-87655-8","vorDoiUrl":"https://doi.org/10.1038/s41598-025-87655-8","workflowStages":[]},"version":"v1","identity":"rs-5243839","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5243839","identity":"rs-5243839","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}