Influence of psoas muscle area on mortality following elective abdominal aortic aneurysm repair.
Aged
Aortic Aneurysm, Abdominal
/ diagnostic imaging
Cohort Studies
Computed Tomography Angiography
/ methods
Elective Surgical Procedures
/ methods
Endovascular Procedures
/ methods
Female
Hospital Mortality
/ trends
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Psoas Muscles
/ diagnostic imaging
Regression Analysis
Sarcopenia
/ diagnostic imaging
Survival Analysis
Treatment Outcome
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
26
07
2018
revised:
24
09
2018
accepted:
05
11
2018
pubmed:
2
2
2019
medline:
7
9
2019
entrez:
2
2
2019
Statut:
ppublish
Résumé
The effect of sarcopenia based on the total psoas muscle area (TPMA) on CT is inconclusive in patients undergoing abdominal aortic aneurysm (AAA) intervention. The aim of this prospective cohort study was to evaluate morphometric sarcopenia as a method of risk stratification in patients undergoing elective AAA intervention. TPMA was measured on preintervention CT images of patients undergoing elective endovascular aneurysm repair (EVAR) or open aneurysm repair. Mortality was assessed in relation to preintervention TPMA using Cox regression analysis, with calculation of hazard ratios at 30 days, 1 year and 4 years. Postintervention morbidity was evaluated in terms of postintervention care, duration of hospital stay and 30-day readmission. Changes in TPMA on surveillance EVAR imaging were also evaluated. In total, 382 patient images acquired between March 2008 and December 2016 were analysed. There were no significant intraobserver and interobserver differences in measurements of TPMA. Preintervention TPMA failed to predict morbidity and mortality at all time points. The mean(s.d.) interval between preintervention and surveillance imaging was 361·3(111·2) days. A significant reduction in TPMA was observed in men on surveillance imaging after EVAR (mean reduction 0·63(1·43) cm TPMA is not a suitable risk stratification tool for patients undergoing effective intervention for AAA.
Sections du résumé
BACKGROUND
The effect of sarcopenia based on the total psoas muscle area (TPMA) on CT is inconclusive in patients undergoing abdominal aortic aneurysm (AAA) intervention. The aim of this prospective cohort study was to evaluate morphometric sarcopenia as a method of risk stratification in patients undergoing elective AAA intervention.
METHODS
TPMA was measured on preintervention CT images of patients undergoing elective endovascular aneurysm repair (EVAR) or open aneurysm repair. Mortality was assessed in relation to preintervention TPMA using Cox regression analysis, with calculation of hazard ratios at 30 days, 1 year and 4 years. Postintervention morbidity was evaluated in terms of postintervention care, duration of hospital stay and 30-day readmission. Changes in TPMA on surveillance EVAR imaging were also evaluated.
RESULTS
In total, 382 patient images acquired between March 2008 and December 2016 were analysed. There were no significant intraobserver and interobserver differences in measurements of TPMA. Preintervention TPMA failed to predict morbidity and mortality at all time points. The mean(s.d.) interval between preintervention and surveillance imaging was 361·3(111·2) days. A significant reduction in TPMA was observed in men on surveillance imaging after EVAR (mean reduction 0·63(1·43) cm
CONCLUSION
TPMA is not a suitable risk stratification tool for patients undergoing effective intervention for AAA.
Identifiants
pubmed: 30706453
doi: 10.1002/bjs.11074
pmc: PMC7938852
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
367-374Subventions
Organisme : British Heart Foundation
ID : FS/18/30/33647
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2019 BJS Society Ltd. Published by John Wiley & Sons Ltd.
Références
Br J Radiol. 2018 Jul;91(1088):20180067
pubmed: 29745763
Br J Surg. 2017 Feb;104(3):166-178
pubmed: 28160528
J Vasc Surg. 2008 Mar;47(3):676-81
pubmed: 18207352
Age Ageing. 2010 Jul;39(4):412-23
pubmed: 20392703
J Vasc Surg. 2018 Feb;67(2):453-459
pubmed: 28847662
J Vasc Surg. 2018 Feb;67(2):460-467
pubmed: 28843791
Eur J Vasc Endovasc Surg. 2008 Dec;36(6):637-45
pubmed: 18922709
J Vasc Surg. 2011 May;53(5):1167-1173.e1
pubmed: 21276681
Lancet. 2004 Sep 4-10;364(9437):843-8
pubmed: 15351191
Anaesthesia. 2015 Jun;70(6):654-65
pubmed: 25959175
Lancet. 2005 Jun 25-Jul 1;365(9478):2187-92
pubmed: 15978926
Eur J Vasc Endovasc Surg. 2018 Jan;55(1):83-91
pubmed: 29158067
Surgery. 2014 Sep;156(3):521-7
pubmed: 24929435
Vasc Med. 2016 Jun;21(3):217-22
pubmed: 26850115
World J Surg. 2017 Sep;41(9):2266-2279
pubmed: 28386715
Liver Transpl. 2014 Apr;20(4):401-7
pubmed: 24357065
Liver Transpl. 2014 Jun;20(6):640-8
pubmed: 24678005
N Engl J Med. 2005 Jun 9;352(23):2398-405
pubmed: 15944424
Surgeon. 2018 Dec;16(6):325-332
pubmed: 29669697
Lancet. 2016 Nov 12;388(10058):2366-2374
pubmed: 27743617
Br J Anaesth. 2015 Mar;114(3):430-6
pubmed: 25481223
JCSM Clin Rep. 2018 Jan-Jun;3(1):
pubmed: 30984911
Eur J Vasc Endovasc Surg. 2011 Jan;41 Suppl 1:S1-S58
pubmed: 21215940
J Vasc Surg. 2011 Apr;53(4):912-7
pubmed: 21215580
Ann Vasc Surg. 2018 Feb;47:90-97
pubmed: 28887259
JAMA. 2009 Oct 14;302(14):1535-42
pubmed: 19826022