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Adverse Outcomes after Advanced EVAR in Patients with Sarcopaenia.

Abstract：

PURPOSE:To determine whether low total psoas muscle area (tPMA), as a surrogate for sarcopaenia, is a predictor of adverse outcomes in patients undergoing advanced EVAR. MATERIALS AND METHODS:A retrospective review of medical records was performed for 257 patients who underwent advanced EVAR (fenestrated or branched technique) in a single tertiary centre from 1 January 2008 to 1 September 2019. The study cohort was divided into tertiles based on tPMA measurement performed independently by two observers from a peri-procedural CT scan at the level of mid-L3 vertebral body. The low tertile was considered sarcopaenic. Logistic regression analysis was used to assess the association of tPMA with 30-day mortality and post-procedural complications. Univariable analysis and adjusted multivariable Cox regression were used to assess the association of tPMA with all-cause mortality. RESULTS:A total of 257 patients comprised 193 males and 64 females with the mean age of 75.4 years (± 6.8) were included. Adjusted multivariable Cox regression revealed an 8% reduction in all-cause mortality for every 1 cm2 increase in tPMA, P < 0.05. TPMA was associated with 30-day mortality (OR 0.85, 95% CI 0.75-0.96, P < 0.05) and spinal cord ischaemia (SCI) (OR 0.89, 95% CI 0.82-0.97, P < 0.05). For remaining post-procedural complications, tPMA was not a useful predictive tool. TPMA correlated negatively with hospital stay length (rs-0.26, P < 0.001). Patients with lower tPMA were more likely to be discharged to a rehabilitation center (OR 0.93, 95% CI 0.87-0.98 , P < 0.05). CONCLUSION:Measurement of tPMA can be a useful predictive tool for adverse outcomes after advanced EVAR. LEVEL OF EVIDENCE:Level 3, Retrospective cohort study.

journal_name

Cardiovasc Intervent Radiol

journal_title

Cardiovascular and interventional radiology

authors

Alenezi AO,Tai E,Jaberi A,Brown A,Mafeld S,Roche-Nagle G

doi

10.1007/s00270-020-02721-0

subject

Has Abstract

pub_date

2021-01-03 00:00:00

eissn

0174-1551

issn

1432-086X

pii

10.1007/s00270-020-02721-0

pub_type

杂志文章

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