The association between sarcopenia and adverse outcomes after complex endovascular aortic repair.

Autor:	Warmerdam BW; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands., van Rijswijk CS; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands., Droop A; Department of Dietetics, Leiden University Medical Center, Leiden, the Netherlands., Lucassen CJ; Department of Dietetics, Leiden University Medical Center, Leiden, the Netherlands., Hamming JF; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands., van Schaik J; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands., van der Vorst JR; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands - j.r.van_der_vorst@lumc.nl.
Jazyk:	angličtina
Zdroj:	The Journal of cardiovascular surgery [J Cardiovasc Surg (Torino)] 2024 Jun; Vol. 65 (3), pp. 256-264. Date of Electronic Publication: 2023 Nov 21.
DOI:	10.23736/S0021-9509.23.12821-7
Abstrakt:	Background: Sarcopenia is identified as a predictive factor for adverse outcomes after complex endovascular aortic repair (complex EVAR). Consensus on preferred parameters for sarcopenia is not yet reached. The current study compares three CT-assessed parameters on their association with adverse outcomes after complex EVAR. Methods: This was a single-center retrospective cohort study. Psoas Muscle Index (PMI), Skeletal Muscle Index (SMI), and lean psoas muscle area (LPMA) were examined by CT-segmentation. PMI, SMI, and LPMA were analyzed as continuous variables. In addition, cut-off values from previous research were used to diagnose patients as sarcopenic or non-sarcopenic. Outcomes were: all-cause mortality, major adverse events (MAE), length of hospital stay, and non-home discharge. A sub-analysis was made for severe sarcopenia; sarcopenia combined with low physical performance (gait speed, Time Up and Go test, Metabolic Equivalent of Task-score). Results: We included 101 patients. A higher PMI (HR=0.590, CI: 0.374-0.930, P=0.023), SMI (HR=0.453, CI: 0.267-0.768, P=0.003), and LPMA (HR=0.559, CI: 0.333-0.944, P=0.029) were associated with a lower risk of mortality. Sarcopenia based on cut-off values for PMI and LPMA was not significantly associated with survival. Sarcopenia based on SMI did present a higher mortality risk (P=0.017). A sub-analysis showed that severely sarcopenic patients were at even higher risk of mortality (P=0.036). None of the parameters were significantly associated with the other outcomes. Conclusions: SMI had a slightly stronger association with mortality compared to PMI and LPMA. High-risk patients were selected by adding physical performance scores. Future research could focus on complex EVAR-specific PMI and LPMA cut-off values.
Databáze:	MEDLINE
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