Sarcopenia is associated with blood transfusions in head and neck cancer free flap surgery

Jones, Alexander Joseph; Campiti, Vincent J.; Alwani, Mohamedkazim; Novinger, Leah J.; Tucker, Brady J.; Bonetto, Andrea; Yesensky, Jessica; Sim, Michael W.; Moore, Michael G.; Mantravadi, Avinash V.

doi:10.1002/lio2.530

Cited by 12 publications

(11 citation statements)

References 61 publications

(117 reference statements)

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“…Some studies have attempted to elucidate the correlation between sarcopenia and postoperative blood transfusion. Sarcopenia is thought to be associated with blood transfusions in head and neck cancer free-flap surgery [ 38 ]. Ardeljan et al studied 90,438 patients who had undergone primary TKA; 16.7% of them had sarcopenia.…”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiology of the increased rate of transfusions in sarcopenic patients is unclear. However, it might be related to the role of skeletal muscle as a vascular reservoir, given its high capillary density compared to other soft tissues such as adipose tissue [ 38 ]. Because sarcopenic patients have lower skeletal muscle mass, their total blood volume is also reduced and these patients might be more susceptible to blood loss [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

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Low muscle mass is an independent risk factor for postoperative blood transfusion in total knee arthroplasty: a retrospective, propensity score-matched cohort study

et al. 2022

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Background Sarcopenia, an age-related loss of skeletal muscle mass and function, is correlated with adverse outcomes after some surgeries. This study examined the characteristics of sarcopenic patients undergoing primary total knee arthroplasty (TKA), and identified low muscle mass as an independent risk factor for postoperative TKA complications. Methods A retrospective cohort study examined 452 patients who underwent TKA. The skeletal muscle index (SMI) was obtained via bioelectrical impedance analysis (BIA), along with demographics, the Charlson Comorbidity Index, and medication, laboratory and operative data for 2018–2021. Patients were categorized into normal (n = 417) and sarcopenic (n = 35) groups using the SMI cut-off suggested by the Asian Working Group for Sarcopenia 2019 (males, < 7.0 kg/m2; females, < 5.7 kg/m2). Three postoperative complications were analysed: blood transfusion, delirium, and acute kidney injury (AKI). Baseline characteristics were propensity score-matched to address potential bias and confounding factors. Results The proportion of sarcopenic patients in primary TKA was 7.7% (35/452). The sarcopenic group had a lower preoperative haemoglobin (12.18 ± 1.20 vs. 13.04 ± 1.73 g/dL, p = 0.004) and total protein (6.73 ± 0.42 vs. 7.06 ± 0.44 mg/dL, p = 0.001). Propensity scoring matching and logistic regression showed that more patients in the sarcopenic group received postoperative blood transfusions (OR = 6.60, 95% CI: 1.57–45.5, p = 0.021); there was no significant difference in AKI or delirium. Univariate receiver operating characteristic curve analysis of the propensity-matched group, to determine the predictive value of SMI for postoperative transfusion, gave an AUC of 0.797 (0.633–0.96) and SMI cut-off of 5.6 kg/m2. Conclusions Low muscle mass determined by BIA was an independent risk factor for postoperative transfusion in TKA. Multifrequency BIA can serve as a screening tool for sarcopenia that may influence the orthopaedic decision-making process or treatment planning in patients with sarcopenia undergoing primary TKA. Level of evidence III, retrospective cohort study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Low muscle mass is an independent risk factor for postoperative blood transfusion in total knee arthroplasty: a retrospective, propensity score-matched cohort study

et al. 2022

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“…In a cohort of 206 HNC patients, SMM was found to be independently associated with discharge to these facilities, with such as discharge. The authors concluded that SMI should be considered in preopera-tive planning of these patients [48].…”

Section: Surgerymentioning

confidence: 99%

Sarcopenia and its impact in head and neck cancer treatment

Bree

Beers

Schaeffers

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewThe aim of this review is to discuss recent studies on the assessment of sarcopenia and its predictive and prognostic value in head and neck cancer (HNC) patients. Recent findingsThere is increasing evidence that low skeletal muscle mass (SMM), often named sarcopenia, can easily be assessed on cross-sectional imaging of the head and neck and is associated with chemotherapy (dose limiting) and radiotherapy toxicity and survival. SummarySMM measurement at the level of the third cervical vertebra (C3) on routine computed tomography and magnetic resonance imaging is easy and robust to perform. Several studies have shown a significantly higher incidence of cisplatin dose limiting toxicity in HNC patients with a low SMM. In HNC patients pretreatment low SMM is associated with acute and late toxicity and adverse events of radiotherapy, complications of major head and neck surgery and decreased disease-specific and overall survival. This information can be used for individualized treatment planning in HNC patients with low SMM.

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“…Thirty preoperative variables were initially chosen as candidate predictors based on previous studies [12,14,[42][43][44]. The preoperative variables included patient demographic information, comorbidities, laboratory data and the proposed sarcopenia marker (PMV) (Supplementary Tables S1 and S2).…”

Section: Machine Learning Model For Sarcopenia Predictionmentioning

confidence: 99%

“…Sarcopenia, characterised as age-related loss of skeletal muscle mass and function, has attracted a great deal of interest because of its reported association with an increased likelihood of poor clinical outcomes, including falls, fractures, physical disability and mortality [10]. Recent studies have showed that sarcopenia independently predicts adverse outcomes of various surgical procedures, including TKA [11][12][13][14]. Therefore, there is increasing recognition of the importance of preoperative risk stratification by screening orthopaedic surgery patients for sarcopenia [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Deep Learning-Based Muscle Segmentation and Quantification of Full-Leg Plain Radiograph for Sarcopenia Screening in Patients Undergoing Total Knee Arthroplasty

Hwang

Ahn

Park

et al. 2022

JCM

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Sarcopenia, an age-related loss of skeletal muscle mass and function, is correlated with adverse outcomes after some surgeries. Here, we present a deep-learning-based model for automatic muscle segmentation and quantification of full-leg plain radiographs. We illustrated the potential of the model to predict sarcopenia in patients undergoing total knee arthroplasty (TKA). A U-Net-based deep learning model for automatic muscle segmentation was developed, trained and validated on the plain radiographs of 227 healthy volunteers. The radiographs of 403 patients scheduled for primary TKA were reviewed to test the developed model and explore its potential to predict sarcopenia. The proposed deep learning model achieved mean IoU values of 0.959 (95% CI 0.959–0.960) and 0.926 (95% CI 0.920–0.931) in the training set and test set, respectively. The fivefold AUC value of the sarcopenia classification model was 0.988 (95% CI 0.986–0.989). Of seven key predictors included in the model, the predicted muscle volume (PMV) was the most important of these features in the decision process. In the preoperative clinical setting, wherein laboratory tests and radiographic imaging are available, the proposed deep-learning-based model can be used to screen for sarcopenia in patients with knee osteoarthritis undergoing TKA with high sarcopenia screening performance.

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Sarcopenia is associated with blood transfusions in head and neck cancer free flap surgery

Cited by 12 publications

References 61 publications

Low muscle mass is an independent risk factor for postoperative blood transfusion in total knee arthroplasty: a retrospective, propensity score-matched cohort study

Low muscle mass is an independent risk factor for postoperative blood transfusion in total knee arthroplasty: a retrospective, propensity score-matched cohort study

Sarcopenia and its impact in head and neck cancer treatment

Deep Learning-Based Muscle Segmentation and Quantification of Full-Leg Plain Radiograph for Sarcopenia Screening in Patients Undergoing Total Knee Arthroplasty

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