Psoas Muscle Index as a Predictor of Perioperative Outcomes in Geriatric Patients Undergoing Spine Surgery.

Autor:	Pernik MN; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Hicks WH; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Akbik OS; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Nguyen ML; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Luu I; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Traylor JI; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Deme PR; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Dosselman LJ; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Hall K; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Wingfield SA; Department of Internal Medicine, Geriatrics Division, UT Southwestern Medical School, Dallas, TX, USA., Aoun SG; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA., Bagley CA; Department of Neurological Surgery, UT Southwestern Medical School, Dallas, TX, USA.; Department of Orthopedic Surgery, UT Southwestern Medical School, Dallas, TX, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2023 Sep; Vol. 13 (7), pp. 2016-2024. Date of Electronic Publication: 2022 Jan 16.
DOI:	10.1177/21925682211072626
Abstrakt:	Study Design: Single-center retrospective study. Objective: The objective of this study was to evaluate the association of psoas muscle mass defined sarcopenia with perioperative outcomes in geriatric patients undergoing elective spine surgery. Methods: We included geriatric patients undergoing thoracolumbar spinal surgery. Total psoas surface area (TPA) was measured on preoperative axial computerized tomography or magnetic resonance imaging at the L3 vertebra and normalized to the L3 vertebral body area. Patients were divided into quartiles by normalized TPA, and the fourth quartile (Q4) was compared to quartiles 1-3 (Q1-3). Outcomes included perioperative transfusions, length of stay (LOS), delirium, pseudoarthrosis, readmission, discharge disposition, revision surgery, and mortality. Results: Of the patients who met inclusion criteria (n = 196), the average age was 73.4 y, with 48 patients in Q4 and 148 patients in Q1-3. Q4 normalized TPA cut-off was <1.05. Differences in Q4 preoperative characteristics included significantly lower body mass index, baseline creatinine, and a greater proportion of females (Table 1). Q4 patients received significantly more postoperative red blood cell and platelet transfusions and had longer ICU LOS ( P < .05; Table 2). There was no difference in intraoperative transfusion volumes, delirium, initiation of walking, discharge disposition, readmission, pseudoarthrosis, or revision surgery (Tables 2 and 3). Mortality during follow-up was higher in Q4 but was not statistically significant ( P = .075). Conclusion: Preoperative TPA in geriatric patients undergoing elective spine surgery is associated with increased need for intensive care and postoperative blood transfusion. Preoperative normalized TPA is a convenient measurement and could be included in geriatric preoperative risk assessment algorithms.
Databáze:	MEDLINE
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