Qualitative and quantitative ultrasonographic assessment of muscle and its association with comprehensive geriatric assessment results among older patients scheduled for abdominal surgery.

Aim: Sarcopenia, a key component of frailty, is a known risk factor for postoperative morbidity and mortality. This study aimed to assess ultrasonographic features of aging muscles and their association with frailty, as determined by the comprehensive geriatric assessment, in patients undergoing elective surgery. As a secondary objective, we evaluated the utility of muscle ultrasound in predicting postoperative complications. Material and methods: Patients were assessed upon admission to the Department of General Surgery at the University Hospital in Krakow. The study enrolled 84 surgical patients aged 65 years and older. They underwent ultrasound examination of the right rectus femoris muscle and the comprehensive geriatric assessment. Preoperative findings were correlated with data on the postoperative course, including length of hospitalization and occurrence of adverse events. Results: Frail patients had smaller rectus femoris muscles with higher echogenicity than fit patients. Muscle size parameters significantly correlated with muscle strength, and rectus femoris cross-sectional area emerged as an independent predictor of handgrip strength in the regression model. Increased rectus femoris echogenicity was associated with higher odds of frailty, while reduced rectus femoris muscle thickness was linked to probable sarcopenia. Notably, associations between muscle measurements and physical performance were stronger in men than in women. No strong correlations were observed between ultrasonographic muscle measurements and the occurrence or severity of postoperative complications. Conclusions: Ultrasound-based muscle measurements showed weak to moderate associations with strength and physical fitness, but had limited predictive value for postoperative outcomes. While potentially complementary to the comprehensive geriatric assessment, the clinical utility of ultrasound remains uncertain and warrants validation in larger studies.