Influence of psoas muscle area on mortality following elective abdominal aortic aneurysm repair.
Br J Surg
; 106(4): 367-374, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30706453
ABSTRACT
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) cm2 per m2 ; P < 0·001). However, this was not associated with mortality (adjusted hazard ratio 1·00, 95 per cent c.i. 0·99 to 1·01; P = 0·935).CONCLUSION:
TPMA is not a suitable risk stratification tool for patients undergoing effective intervention for AAA.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Músculos Psoas
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Aneurisma de la Aorta Abdominal
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Procedimientos Quirúrgicos Electivos
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Sarcopenia
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Procedimientos Endovasculares
/
Angiografía por Tomografía Computarizada
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Br J Surg
Año:
2019
Tipo del documento:
Article
País de afiliación:
Reino Unido