Computed tomography -defined sarcopenia is associated with long-term survival among patients undergoing open thoracic aortic reconstruction.

IF 2.5 3区医学 Q1 SURGERY

Scandinavian Journal of Surgery Pub Date : 2024-06-01 Epub Date: 2023-12-14 DOI:10.1177/14574969231213758

Salla Valkkio, Sohvi Kuoppala, Iisa Lindström, Niina Khan, Thanos Sioris, Jari Laurikka, Niku Oksala, Jussi Hernesniemi

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引用次数: 0

Abstract

Background and objective: As markers of sarcopenia, psoas muscle areas and indexes measured from computed tomography images have been found to predict long-term mortality in cardiothoracic as well as other surgical cohorts. Our objective was to investigate the association between psoas muscle status, taking into account muscle density in addition to area, and survival among patients undergoing open thoracic aortic reconstruction.

Methods: This was a retrospective registry study of a total of 451 patients treated with open surgery for thoracic aortic pathology. Psoas muscle area and density were measured from preoperative computed tomography images at the L3 and L4 lumbar levels. In addition, lean psoas muscle area was calculated by averaging sex-specific values of psoas muscle area and density. The association between mortality and psoas muscle status was analyzed with adjusted Cox-regression analysis.

Results: The median age of the study population was 63 (interquartile range (IQR): 53-70) years. The majority were male (74.7%, n = 337) and underwent elective procedures (58.1% n = 262). Surgery of the ascending aorta was carried out in 90% of the patients, and 15% (n = 67) had concomitant coronary artery bypass surgery. Aortic dissection was present in 34.6% (n = 156) patients. Median follow-up time was 4.3 years (IQR: 2.2-7.4). During the follow-up, 106 patients (23.5%) died, with 55.7% of deaths occurring within the first four postoperative weeks. Psoas muscle parameters were not associated with perioperative mortality, but significant independent associations with long-term mortality were observed for psoas muscle area, density, and lean psoas muscle area with hazard ratios (HRs) of 0.63 (95% confidence interval (CI): 0.45-0.88), 0.62 (95% CI: 0.46-0.83), and 0.47 (95% CI: 0.32-0.69), respectively (all per 1-SD increase).

Conclusions: Psoas muscle sarcopenia status is associated with long-term mortality after open thoracic aortic surgery.

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计算机断层扫描确定的肌肉疏松症与接受开胸主动脉重建术的患者的长期存活率有关。

背景和目的：作为肌肉疏松症的标志，通过计算机断层扫描图像测量的腰肌面积和指数可预测心胸手术和其他手术组群的长期死亡率。我们的目的是研究腰肌状态（除面积外还考虑肌肉密度）与开胸主动脉重建患者生存之间的关系：这是一项回顾性登记研究，共对 451 名接受开胸主动脉病理手术治疗的患者进行了研究。腰肌面积和密度是通过术前腰椎 L3 和 L4 位置的计算机断层扫描图像测量的。此外，还通过计算腰肌面积和密度的性别特异性平均值来计算瘦腰肌面积。通过调整后的 Cox 回归分析，分析了死亡率与腰肌状态之间的关系：研究对象的中位年龄为 63 岁（四分位距（IQR）：53-70）。大部分为男性（74.7%，n = 337），接受了选择性手术（58.1%，n = 262）。90%的患者接受了升主动脉手术，15%（n = 67）的患者同时接受了冠状动脉搭桥手术。34.6%（156 人）的患者存在主动脉夹层。中位随访时间为 4.3 年（IQR：2.2-7.4）。在随访期间，106 名患者（23.5%）死亡，其中 55.7% 的死亡发生在术后头四周内。腰肌参数与围手术期死亡率无关，但观察到腰肌面积、密度和瘦腰肌面积与长期死亡率有显著的独立关联，危险比（HRs）分别为0.63（95% 置信区间（CI）：0.45-0.88）、0.62（95% CI：0.46-0.83）和0.47（95% CI：0.32-0.69）（均为每增加1SD）：腰肌疏松状态与开胸主动脉手术后的长期死亡率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scandinavian Journal of Surgery 医学-外科

CiteScore

5.50

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The Scandinavian Journal of Surgery (SJS) is the official peer reviewed journal of the Finnish Surgical Society and the Scandinavian Surgical Society. It publishes original and review articles from all surgical fields and specialties to reflect the interests of our diverse and international readership that consists of surgeons from all specialties and continents.