Cardiopulmonary exercise testing, computed tomography-derived body composition, systemic inflammation and survival after elective abdominal aortic aneurysm repair: A retrospective cohort study.
Eur J Anaesthesiol
; 41(7): 490-499, 2024 Jul 01.
Article
em En
| MEDLINE
| ID: mdl-38757161
ABSTRACT
BACKGROUND:
Cardio-pulmonary exercise testing (CPEX) is selectively used before intervention for abdominal aortic aneurysm (AAA). Sarcopenia, a chronic condition defined by reduced skeletal muscle function and volume, can be assessed radiologically by computed tomography (CT)-derived body composition analysis (CT-BC), and is associated with systemic inflammation.OBJECTIVE:
The aim was to describe the association between CT-BC, CPEX, inflammation and survival in patients undergoing elective intervention for AAA.SETTING:
Patients were recruited retrospectively from a single, secondary-care centre-operative database. Cases undergoing elective endovascular aneurysm repair (EVAR) and open surgical repair (OSR) between 31 March 2015 and 25 June 2020 were included. PATIENTS There were 176 patients (130 EVAR, 46 OSR) available for analysis in the final study; median (interquartile range [IQR]) follow-up was 60.5 [27] months, and all completed a minimum of 2âyears follow-up. MAIN OUTCOMEMEASURES:
Preoperative CPEX tests were recorded. CT sarcopenia score [CT-SS, range 0 to 2, calculated based on normal/low SMI (0/1) and normal/low SMD (0/1)] assessed radiological sarcopenia. Preoperative modified Glasgow Prognostic score (mGPS) was used to assess systemic inflammation.RESULTS:
Mean [95% confidence interval (CI) survival in the CT-SS 0 vs. CT-SS 1 vs. CT-SS 2 subgroups was 80.1 (73.6 to 86.6) months vs. 70.3 (63.5 to 77.1) months vs. 63.8 (53.4 to 74.2) months] ( P â=â0.01). CT-SS was not associated with CPEX results ( P â>â0.05). Elevated CT-SS [hazard ratio (HR) 1.83, 95% CI, 1.16 to 2.89, P â<â0.01] was independently associated with increased hazard of long-term mortality; however, CPEX results were not ( P â>â0.05).CONCLUSION:
CPEX test results were not consistently associated with body composition and did not have significant prognostic value in patients undergoing elective treatment for AAA.
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Composição Corporal
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Tomografia Computadorizada por Raios X
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Aneurisma da Aorta Abdominal
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Procedimentos Cirúrgicos Eletivos
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Teste de Esforço
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Sarcopenia
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Inflamação
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Anaesthesiol
/
Eur. j. anaesthesiol
/
European journal of anaesthesiology
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article