Prognostic relevance of CT-defined body composition in patients with acute bleeding undergoing endovascular embolization.

Abstract

Objectives: Body composition assessment includes the parameter skeletal muscle mass, subcutaneous and visceral adipose tissue (SAT and VAT). The purpose of this study was to elucidate associations of body composition parameters with mortality in patients with acute bleeding undergoing transarterial embolization (TAE).

Methods: A mixed cohort of patients from 2018 to 2022 with acute bleeding requiring treatment with a TAE was retrospectively evaluated. In every case, the triphasic CT to diagnose the source of bleeding was used to calculate the body composition parameters.

Results: A total of 251 patients (93 female, 37.1%) with a mean age of 65.5 ± 14.3 years, 30-d mortality of 40.2%, and 24-h mortality of 7.6% were included in the analysis. In the Cox regression analysis, no statistically significant correlations were found between the body composition parameters and 24-h or 30-day mortality. In the subgroup analysis of patients aged older than 65 years, skeletal muscle index was associated with short-term 24-h mortality HR of 0.95 (95% CI 0.90; 0.99, P = .035).

Conclusions: The present study demonstrated the prognostic impact of clinical, laboratory, aniography-related, and CT-defined body composition in patients with acute haemorrhage undergoing endovascular therapy. Although the overall effect of CT-defined body composition appears to be small, skeletal muscle index was a prognostic factor in the age group over 65 years.

Advances in knowledge: This is a large single-centre study to investigate the prognostic relevance of CT-defined body composition in patients undergoing TAE. The effect is overall small but might be further investigated in older patients in further trials.