Computed tomography–derived skeletal muscle index: A novel predictor of frailty and hospital length of stay after transcatheter aortic valve replacement

Dahya, Vishal; Xiao, Jingjie; Prado, Carla M.; Burroughs, Penny; McGee, Dan; Silva, Aline C.; Hurt, Julian E.; Mohamed, Shafi; Noel, Thomas; Batchelor, Wayne

doi:10.1016/j.ahj.2016.08.016

Cited by 48 publications

(29 citation statements)

References 42 publications

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“…However, most other studies have measured SMA in the same way as in this study and in several studies for intraobserver agreement for SMA measured by CT, the intraobserver coefficient variation was only 1.3%–2.0%. 39 40 Finally, sarcopenia in this study was evaluated only in terms of muscle mass not muscle function.…”

Section: Discussionmentioning

confidence: 99%

Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis

et al. 2018

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BackgroundSarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis.MethodsWe included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements.ResultsA total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (ΔSMA/y) were −0.89%. During a median follow-up period of 46.2 months (range, 3.4–87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ΔSMA/y were independently associated with mortality. Cumulative mortality was significantly higher in patients with ΔSMA/y < −2.4% than those with ΔSMA/y ≥ −2.4% (log-rank test, P < 0.001).ConclusionBoth the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

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Section: Discussionmentioning

confidence: 99%

Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis

et al. 2018

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“…Skeletal muscle radiodensity reflects fat infiltration into muscle . To date, the largest study investigating SMD included 1473 patients with lung or gastrointestinal tract cancer, showing this abnormality as an independent predictor of shorter survival .…”

Section: Introductionmentioning

confidence: 99%

“…7,9,10 Skeletal muscle radiodensity reflects fat infiltration into muscle. 11 To date, the largest study investigating SMD included 1473 patients with lung or gastrointestinal tract cancer, showing this abnormality as an independent predictor of shorter survival. 12 Additional studies have reported that low SMD was associated with complications and short-term mortality after surgery in CRC and in other types of cancer.…”

Section: Introductionmentioning

confidence: 99%

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Xiao

Caan

Weltzien

et al. 2018

J cachexia sarcopenia muscle

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Background and aimCo‐morbidities and computerized tomography‐measured muscle abnormalities are both common in cancer patients and independently adversely influence clinical outcomes. Muscle abnormalities are also evident in other diseases, such as diabetes and obesity. This study examined for the first time the association between co‐morbidities and muscle abnormalities in patients diagnosed with colorectal cancer (CRC).MethodsThis cross‐sectional study included 3051 non‐metastatic patients with Stages I–III CRC. Muscle abnormalities, measured at diagnosis, were defined as low skeletal muscle mass index (SMI) or low skeletal muscle radiodensity (SMD) quantified using computerized tomography images using optimal stratification. Co‐morbidities included in the Charlson index were ascertained. χ2 tests were used to compare the prevalence of co‐morbidities by the presence or absence of each muscle abnormality. Logistic regressions were performed to evaluate which co‐morbidities predicted muscle abnormalities adjusting for age, sex, body mass index, weight change, cancer stage, cancer site, race/ethnicity, and smoking.ResultsMean age was 63 years; 50% of patients were male. The prevalence of low SMI and low SMD were 43.1% and 30.2%, respectively. Co‐morbidities examined were more prevalent in patients with low SMD than in those with normal SMD, and most remained independent predictors of low SMD after adjustment for covariates. Co‐morbidities associated with higher odds of low SMD included myocardial infarction [odds ratio (OR) = 1.77, P = 0.023], congestive heart failure (OR = 3.27, P < 0.001), peripheral vascular disease (OR = 2.15, P = 0.002), diabetes with or without complications (OR = 1.61, P = 0.008; OR = 1.46, P = 0.003, respectively), and renal disease (OR = 2.21, P < 0.001). By contrast, only diabetes with complications was associated with lower odds of low SMI (OR = 0.64, P = 0.007).ConclusionsPrevalence of muscle abnormalities was high in patients with non‐metastatic CRC. Pre‐existing co‐morbidities were associated with low SMD, suggestive of a potential shared mechanism between fat infiltration into muscle and each of these co‐morbidities.

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“…Additionally, a study assessing preoperative computed tomography (CT) scans that are done as part of the workup for transcatheter therapeutic interventions for VHD shows that these CTs have proven useful in measuring the patient's skeletal mass index (SMI) and, thus, preoperative sarcopenia. This correlated directly to length of stay more strongly than the frailty index [107].…”

Section: Frailty and Valvular Heart Disease (Vhd)mentioning

confidence: 93%

Frailty and Cardiovascular Disease

Chainani¹,

Riehl²,

Chainani³

et al. 2017

Frailty and Sarcopenia - Onset, Development and Clinical Challenges

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Cardiovascular disease (CVD) comprises a vast spectrum of disease states ranging from hypertension (HTN) to valvular heart disease (VHD). CVD is known to be the leading cause of morbidity, mortality, and health-care expenditure throughout the world. According to the World Health Organization, coronary artery disease (CAD) and stroke, both subsets of CVD, are the world's biggest killers, accounting for a combined 15 million deaths in 2015. These diseases have remained the leading causes of death globally in the last 15 years. In 2010, CAD alone was projected to cost the U.S. $108.9 billion including the cost of health-care services, medications, and lost productivity. The presence of frailty signiicantly worsens outcomes for patients sufering from CAD. With just this one example of how frailty afects CVD, it is clear that understanding the impact of frailty upon patients alicted with the spectrum of cardiovascular disease is integral for the care of this very signiicant patient population.

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Computed tomography–derived skeletal muscle index: A novel predictor of frailty and hospital length of stay after transcatheter aortic valve replacement

Cited by 48 publications

References 42 publications

Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis

Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Frailty and Cardiovascular Disease

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