Morphometric Assessment as a Predictor of Outcome in Older Vascular Surgery Patients

Chowdhury, Mohammed M.; Ambler, Graeme K.; Zuhir, Naail Al; Walker, Alex J; Atkins, E.R.; Winterbottom, Andrew; Coughlin, Patrick A.

doi:10.1016/j.avsg.2017.08.002

Cited by 12 publications

(10 citation statements)

References 42 publications

(42 reference statements)

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“…on their comprehensive article, describing the influence of total psoas muscle area (TPMA) on mortality following elective abdominal aortic aneurysm (AAA) repair. We were struck by the similarity between the authors' findings and those of our own group. Similar to Waduud et al ., we found that TPMA is a poor indicator of mortality in general vascular surgery patients.…”

supporting

confidence: 65%

Correspondence

Wardle

Ambler

Twine

et al. 2019

British Journal of Surgery

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supporting

confidence: 65%

Correspondence

Wardle

Ambler

Twine

et al. 2019

British Journal of Surgery

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“…The hypothesis of this study was that TPMA might therefore be a useful clinical adjunct for risk stratification in patients with an AAA. Associations between sarcopenia and adverse outcomes have been reported following elective AAA intervention. This finding was not, however, replicated by Heard and colleagues in a cohort of vascular patients in the UK.…”

Section: Introductionmentioning

confidence: 87%

Influence of psoas muscle area on mortality following elective abdominal aortic aneurysm repair

Waduud

Wood

Keleabetswe

et al. 2019

British Journal of Surgery

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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 2 per m 2 ; 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.

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“…In addition, there were also reported variations in the vertebral level at which measurements were performed. The studies by Chowdhury et al . and Heard et al .…”

mentioning

confidence: 99%

“…It is important to note that the results of previous studies must be interpreted with caution. First, it remains unclear whether any of these were adequately powered to detect the stated outcome measures.…”

mentioning

confidence: 99%