Prognostic implications of psoas muscle area in patients undergoing transcatheter aortic valve implantation
Autor: | Bernhard Metzler, Sebastian J. Reinstadler, Nikolaos Bonaros, Michael Grimm, Markus Kofler, Agnes Mayr, Christian J. Rustenbach, Julia Dumfarth, Theresa M Dachs, Guy Friedrich, Kristina Wachter, Gert Klug, Peter Bramlage, Martin Reindl, Hardy Baumbach, Gudrun Feuchtner, Lukas Stastny |
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Rok vydání: | 2018 |
Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty 030204 cardiovascular system & hematology Logistic regression Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Risk Factors Interquartile range Internal medicine Humans Medicine Prospective Studies Prospective cohort study Aged Psoas Muscles Aged 80 and over Body surface area business.industry Proportional hazards model Hazard ratio Aortic Valve Stenosis General Medicine Odds ratio Prognosis Confidence interval 030228 respiratory system Aortic Valve Cardiology Female Surgery Cardiology and Cardiovascular Medicine business |
Zdroj: | European Journal of Cardio-Thoracic Surgery. 55:210-216 |
ISSN: | 1873-734X 1010-7940 |
Popis: | OBJECTIVES This study sought to assess the incremental prognostic value of the psoas muscle area in patients scheduled for transcatheter aortic valve implantation (TAVI). METHODS A total of 1076 consecutive patients undergoing TAVI at 2 centres between 2010 and 2017 were prospectively included in this study. Computed tomography-derived cross-sectional area of the psoas muscle was measured at the superior border of the third (L3) and fourth (L4) lumbar vertebra and indexed to body surface area (PMAi) as well as stratified into tertiles. Multivariable logistic regression and Cox regression analyses were performed to investigate the value of PMAi as a predictor of 30-day and cumulative mortality. The incremental prognostic value of PMAi over the Society of Thoracic Surgeons (STS) score was assessed using a net reclassification analysis. RESULTS The rate of 30-day mortality was 5.8% (n = 62). PMAi at the level of L3 [odds ratio 0.082, 95% confidence interval (CI) 0.011-0.589; P = 0.013] and L4 (odds ratio 0.049, 95% CI 0.005-0.536; P = 0.013) was independently associated with 30-day mortality. During a median follow-up of 435 days (interquartile range 139-904), 292 patients (27.1%) died. PMAi of L3 (hazard ratio 0.200, 95% CI 0.083-0.482; P |
Databáze: | OpenAIRE |
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