P.7 THE ULTRASONIC MEASUREMENT OF UPPER ARN MUSCLE AND FAT AREA.

0. BijHM, K. Wiinsch, M. Baum, M. Odaischi (Dept. of Surgery, Stadt. Krankenhaus, Kaiserslautern, FRG)

The combined variance of anthropometric measurement can produce an error of up to 33 % between different observers. Does the direct ultrasonic measurement at a definite reference point improve the accuracy and the reproducible results?

Midarm muscle area (MAMA) and midarm fat area (MAFA) determined by anthropometric assessment (a) ist compared with the ultrasonic planimetry (us), using CT scanning (CT) as the standard. Data from 15 normal persons (weight range 50 - 95 kg) and 11 over- and underweight patients (33 - 112 kg) amount to the following correlations coefficients:

MAFA (a) MAFA (us) MAMA (a) MAMA (us) normal 0.861 0.845 0.864 0.908 under- over- weight 0.961 0.969 0.889 0.937

Repeated measurements of 3 different observers at the insertion of the must. Deltoideus as our reference point decreased the error to 8,4 %. As a simplified technique of assessment the MAMA inste$d of planimetry we only used the diameters with theje results: MAMA (us) 34,28 cm (mean value), IO,71 (SD), MAMA (CT) 34,95 cm (mv), 12,49 (SD).

Conclusion: The ultrasonic technique is more accurate and reproducible than the anthropometric assessment, as for as a definite reference point is available.

p-8 NUTRITIONAL CONSEQUENCE OF ELECTIVE GENERAL SURGICAL OPERATIONS.

R.A. Richardson, H.J.G. Burns, P. Rodgers, R. Birrell, A. Shenkin. University Department of Surgery and Clinical Biochemistry, Royal Infirmary, Glasgow.

The metabolic response to surgery and its nutritional consequence may be different depending on the preoperative nutritional status of the patient. We examined the effect of elective surgical procedures on body composition prospectively in 44 patients, 14 of whom were classified as normally nourished (Group A) and 30 as malnourished (Group B). Malnourished patients were classified as having triceps skinfold thickness (T.S.F.) less than 80%. Biochemical and anthropometric assessments were carried out on admission and at discharge from hospital. Both groups were well matched in terms of age and disease state, benign and malignant disease being present equally in both groups. There was a predominance of females in Group A (M:F, 5:9) and males were more common in Group B (M:F 2O:lO).

Group A patients lost significantly more body weight (pcO.05) and subcutaneous fat (p<O.OOl Mann Whitney U test) when compared with Group B.

Group A (Mean ? 1SD) Group B Pre-op Discharge

% Weight 108 f l(ja 98 i: 22b % T.S.F. 95 + 16e 59 -t 23'

9;';-;;c D;;cta;;;

51 + 159 51 ? 22 Comparisons (Mann Whitney test) a v c pcO.01; b v d pcO.05; e v f pcO.05;

a v b, c v d, g v h, N.S.

Post-operatively patients in Group B had no significant alteration in body weight, t S F. There was no significant alteration in arm muscle circumference or serum albumin in either group. Length of hospital stay and complication rate was similar in both groups. These results suggest that malnourished patients can adlpt to the weight-losing state and therefore the impact of major surgery on anthropometry was lessened in this group. These results indicate that atte&ts to restore body composition in the pre-op period may alter the post-operative metabolic response.

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