{"title":"腰肌密度比腰肌面积或指数区域更准确地预测择期结直肠手术的结果。","authors":"Louis Scarrold, Douglas Stupart, David Watters","doi":"10.1016/j.tjfa.2025.100037","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>CT measurements of psoas muscle density (PMD) and area (PMA) (with or without indexing to height-squared or body-surface-area) are used interchangeably as sarcopenia measures - it is unknown which best correlates with surgical risk.</p><p><strong>Objectives: </strong>1.Determine the correlation between psoas muscle density, area, and indexed area; 2.Identify which psoas measures most strongly associated with surgical outcomes DESIGN: The University Hospital Geelong Colorectal database included all patients who underwent elective colorectal surgery from 2007 to 2014 (minimum five-years follow-up). Pre-operative CT scans were reviewed, psoas measures correlated with each other and with outcomes.</p><p><strong>Setting: </strong>University Hospital Geelong is a regional referral hospital in Victoria, Australia.</p><p><strong>Participants: </strong>This database listed 552 patients, 120 were excluded as pre-operative CT-films were not accessible, leaving 432 patients included.</p><p><strong>Exposure: </strong>Psoas muscle density, area, and area indexed by height-squared and body-surface-area.</p><p><strong>Measurements: </strong>Pearson correlations investigated correlations between psoas muscle measures. Logistic regression and ROC-analysis investigated each psoas measures association with peri‑operative morbidity. Kaplan-Meier survival-analysis investigated the association of each psoas measure with long-term survival.</p><p><strong>Results: </strong>Mean age was 70.4 years, 41 % were female. Psoas muscle density correlated poorly with area (R<sup>2</sup>=0.15). Unindexed psoas muscle area correlated well with area indexed by height-squared (R<sup>2</sup>=0.950) and body-surface-area (R<sup>2</sup>=0.938). Long-term survival was associated with psoas muscle density (HR1.515(95 %CI 1.062-2.161)) and area (HR1.886(95 %CI 1.322-2.692)). Increasing psoas muscle density (reduced sarcopenia) was associated with decreased major-complications (OR0.963(95 %CI 0.938-0.989)) and peri‑operative mortality (OR0.903(95 %CI 0.847-0.962)), with ROC-curve AUC=0.829 indicating an accurate test. There was no association between psoas muscle area and major-complications (OR1.000(95 %CI 1.000-1.000)), nor peri‑operative mortality (OR1.000(95 %CI 0.999-1.001)), with ROC-curves AUC=0.507-0.521. Indexed area measures were not associated with outcomes.</p><p><strong>Conclusions: </strong>Psoas muscle density and area did not correlate. Both were associated with long-term survival, but only density was associated major-complications and mortality. Indexing removed the correlation of area with long-term survival.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":"14 3","pages":"100037"},"PeriodicalIF":3.3000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Psoas muscle density predicts elective colorectal surgical outcomes more accurately than psoas muscle area or indexed area.\",\"authors\":\"Louis Scarrold, Douglas Stupart, David Watters\",\"doi\":\"10.1016/j.tjfa.2025.100037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>CT measurements of psoas muscle density (PMD) and area (PMA) (with or without indexing to height-squared or body-surface-area) are used interchangeably as sarcopenia measures - it is unknown which best correlates with surgical risk.</p><p><strong>Objectives: </strong>1.Determine the correlation between psoas muscle density, area, and indexed area; 2.Identify which psoas measures most strongly associated with surgical outcomes DESIGN: The University Hospital Geelong Colorectal database included all patients who underwent elective colorectal surgery from 2007 to 2014 (minimum five-years follow-up). Pre-operative CT scans were reviewed, psoas measures correlated with each other and with outcomes.</p><p><strong>Setting: </strong>University Hospital Geelong is a regional referral hospital in Victoria, Australia.</p><p><strong>Participants: </strong>This database listed 552 patients, 120 were excluded as pre-operative CT-films were not accessible, leaving 432 patients included.</p><p><strong>Exposure: </strong>Psoas muscle density, area, and area indexed by height-squared and body-surface-area.</p><p><strong>Measurements: </strong>Pearson correlations investigated correlations between psoas muscle measures. Logistic regression and ROC-analysis investigated each psoas measures association with peri‑operative morbidity. Kaplan-Meier survival-analysis investigated the association of each psoas measure with long-term survival.</p><p><strong>Results: </strong>Mean age was 70.4 years, 41 % were female. Psoas muscle density correlated poorly with area (R<sup>2</sup>=0.15). Unindexed psoas muscle area correlated well with area indexed by height-squared (R<sup>2</sup>=0.950) and body-surface-area (R<sup>2</sup>=0.938). Long-term survival was associated with psoas muscle density (HR1.515(95 %CI 1.062-2.161)) and area (HR1.886(95 %CI 1.322-2.692)). Increasing psoas muscle density (reduced sarcopenia) was associated with decreased major-complications (OR0.963(95 %CI 0.938-0.989)) and peri‑operative mortality (OR0.903(95 %CI 0.847-0.962)), with ROC-curve AUC=0.829 indicating an accurate test. There was no association between psoas muscle area and major-complications (OR1.000(95 %CI 1.000-1.000)), nor peri‑operative mortality (OR1.000(95 %CI 0.999-1.001)), with ROC-curves AUC=0.507-0.521. Indexed area measures were not associated with outcomes.</p><p><strong>Conclusions: </strong>Psoas muscle density and area did not correlate. Both were associated with long-term survival, but only density was associated major-complications and mortality. Indexing removed the correlation of area with long-term survival.</p>\",\"PeriodicalId\":51629,\"journal\":{\"name\":\"Journal of Frailty & Aging\",\"volume\":\"14 3\",\"pages\":\"100037\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Frailty & Aging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.tjfa.2025.100037\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Frailty & Aging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.tjfa.2025.100037","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Psoas muscle density predicts elective colorectal surgical outcomes more accurately than psoas muscle area or indexed area.
Background: CT measurements of psoas muscle density (PMD) and area (PMA) (with or without indexing to height-squared or body-surface-area) are used interchangeably as sarcopenia measures - it is unknown which best correlates with surgical risk.
Objectives: 1.Determine the correlation between psoas muscle density, area, and indexed area; 2.Identify which psoas measures most strongly associated with surgical outcomes DESIGN: The University Hospital Geelong Colorectal database included all patients who underwent elective colorectal surgery from 2007 to 2014 (minimum five-years follow-up). Pre-operative CT scans were reviewed, psoas measures correlated with each other and with outcomes.
Setting: University Hospital Geelong is a regional referral hospital in Victoria, Australia.
Participants: This database listed 552 patients, 120 were excluded as pre-operative CT-films were not accessible, leaving 432 patients included.
Exposure: Psoas muscle density, area, and area indexed by height-squared and body-surface-area.
Measurements: Pearson correlations investigated correlations between psoas muscle measures. Logistic regression and ROC-analysis investigated each psoas measures association with peri‑operative morbidity. Kaplan-Meier survival-analysis investigated the association of each psoas measure with long-term survival.
Results: Mean age was 70.4 years, 41 % were female. Psoas muscle density correlated poorly with area (R2=0.15). Unindexed psoas muscle area correlated well with area indexed by height-squared (R2=0.950) and body-surface-area (R2=0.938). Long-term survival was associated with psoas muscle density (HR1.515(95 %CI 1.062-2.161)) and area (HR1.886(95 %CI 1.322-2.692)). Increasing psoas muscle density (reduced sarcopenia) was associated with decreased major-complications (OR0.963(95 %CI 0.938-0.989)) and peri‑operative mortality (OR0.903(95 %CI 0.847-0.962)), with ROC-curve AUC=0.829 indicating an accurate test. There was no association between psoas muscle area and major-complications (OR1.000(95 %CI 1.000-1.000)), nor peri‑operative mortality (OR1.000(95 %CI 0.999-1.001)), with ROC-curves AUC=0.507-0.521. Indexed area measures were not associated with outcomes.
Conclusions: Psoas muscle density and area did not correlate. Both were associated with long-term survival, but only density was associated major-complications and mortality. Indexing removed the correlation of area with long-term survival.
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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