Psoas Muscle Area Predicts All-Cause Mortality After Endovascular and Open Aortic Aneurysm Repair

Drudi, Laura M.; Phung, Kim; Ades, Matthew; Zuckerman, Jesse; Mullie, Louis; Steinmetz, Oren K.; Obrand, Daniel I.; Afilalo, Jonathan

doi:10.1016/j.ejvs.2016.09.011

Cited by 85 publications

(72 citation statements)

References 33 publications

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“…A CT scan prior to TAVI is routinely performed and PMA measures can be easily obtained. Furthermore, PMA can be measured with high reliability . In our study, we had nearly perfect intra‐observer and intra‐observer agreement.…”

Section: Discussionsupporting

confidence: 58%

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CT determined psoas muscle area predicts mortality in women undergoing transcatheter aortic valve implantation

Mourik

Janmaat

Kesteren

et al. 2018

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 58%

“…Furthermore, PMA can be measured with high reliability. 15,16 In our study, we had nearly perfect intra-observer and intra-observer agreement.…”

Section: Discussionmentioning

confidence: 53%

CT determined psoas muscle area predicts mortality in women undergoing transcatheter aortic valve implantation

Mourik

Janmaat

Kesteren

et al. 2018

Cathet Cardio Intervent

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“…There is a growing body of literature on the negative effect of sarcopenia on surgical outcomes and mortality. Both Lee et al and Drudi et al demonstrated increased risk of mortality after AAA repair with decreasing total psoas muscle (25,26). However, both studies defined sarcopenia based on the lowest tertile within the study group, making their definition susceptible to selection bias.…”

Section: Discussionmentioning

confidence: 96%

Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair

Kays

Liang

Zimmers

et al. 2018

JCSM Clinical Reports

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Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and ResultsPatient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5-year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.88.3 versus 66.88.1 years; p<0.001), had lower body mass index (BMI) (26.35.2 versus 31.55.9 kg/m 2 ; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.614.0 versus 57.811.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% 6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30-day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long-term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one-, three-, and five-year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6-fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone.Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population.

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“…Limb Ischaemia Frailty Index. 25 Six single domain tools were used in 11 studies examining four areas: cognition, 7 function dependency, 32,33,38 central muscle mass, 10,11,36,37,39,40 and nutrition. 35 Six studies were conducted in patients who underwent major vascular surgery, 7,8,28,30,31,34 nine studies in patients with AAA, 11,12,14,27,33,36e39 and 10 studies in patients with LEAD.…”

Section: And Criticalmentioning

confidence: 99%

The Impact of Frailty on Outcomes of Elderly Patients After Major Vascular Surgery: A Systematic Review and Meta-analysis

Wang

Zou

Zhao

et al. 2018

European Journal of Vascular and Endovascular Surgery

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Psoas Muscle Area Predicts All-Cause Mortality After Endovascular and Open Aortic Aneurysm Repair

Abstract: PMA is independently associated with all-cause mortality after elective endovascular and open aortic aneurysm repair, and may be integrated into the pre-operative risk assessment to optimize care in high-risk frail patients.

Cited by 85 publications

References 33 publications

CT determined psoas muscle area predicts mortality in women undergoing transcatheter aortic valve implantation

CT determined psoas muscle area predicts mortality in women undergoing transcatheter aortic valve implantation

Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair

The Impact of Frailty on Outcomes of Elderly Patients After Major Vascular Surgery: A Systematic Review and Meta-analysis

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