Developing sarcopenia predicts long-term mortality after elective endovascular aortic aneurysm repair
| Autor: | Jussi Hernesniemi, Sara Protto, Iisa Lindström, Niku Oksala, Niina Khan, Niko Sillanpää |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Sarcopenia Aortic Rupture Early detection 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aortic aneurysm repair business.industry Proportional hazards model Endovascular Procedures Skeletal muscle medicine.disease Prognosis Abdominal aortic aneurysm Survival Rate medicine.anatomical_structure Cardiology Surgery Long term mortality Female Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed Aortic Aneurysm Abdominal |
| Zdroj: | Journal of vascular surgery. 71(4) |
| ISSN: | 1097-6809 |
| Popis: | Background Preoperatively detected sarcopenia as reflected by psoas muscle area (PMA) is associated with postoperative mortality after abdominal aortic aneurysm (AAA) repair. We studied, whether changes in PMA and lean PMA (LPMA) after endovascular aortic repair (EVAR) are associated with postoperative survival. Methods In 122 AAA patients treated between 2008 and 2016 (90% male; median age, 77.8 years; interquartile range, 11.5; rupture 2.5%) PMA and LPMA at L3 level were measured retrospectively from preoperative and 1- and 3-year follow-up computed tomography (CT) studies. The median duration of follow-up was 6.0 years (interquartile range, 3.5) and all-cause mortality was 46.7%. Association of radiologic muscle parameters with all-cause mortality was evaluated with Cox regression. Clinical data were collected from an institutional database and patient record databases. Results There was a significant decrease in PMA and LPMA at L3 level (mean, −4.4 cm2 [−26.8%] for PMA and −130.4 cm2 × Hounsfield units [−21.6%] for LPMA, respectively; P Conclusions The most significant loss of skeletal muscle occurs during the first year after EVAR. The relative change in PMA from baseline is an independent predictor of mortality. For every 10% unit increase in ΔPMA/baseline CT muscle parameter bilaterally, there was a 21% decrease in the probability of death during follow-up. Early detection (from CT studies) and prevention of sarcopenia may potentially improve survival in EVAR-treated patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|