The Impact of Sarcopenia in the Long-Term Survival of Patients following Complex Endovascular Aortic Surgery for Thoracoabdominal Aortic Aneurysms
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Cohort
2.2. Assessment of Skeletal Muscle
2.3. Study Endpoints
2.4. Statistical Analysis
3. Results
3.1. Cohort Characteristics
3.2. Primary Endpoints
3.3. Secondary Endpoints
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total No. (%) |
---|---|
Male/Female ratio | 86 (63.7%)/49 (36.3%) |
Mean patient age (y.o ± SD) | 69.7 ± 8.6 |
BMI (kg/m2 ± SD) | 26.9 ± 4.6 |
ASA grading | |
| 17 (12.6%) |
| 104 (77%) |
| 14 (10.4%) |
Type of TAAA | |
| 8 (5.9%) |
| 44 (32.6%) |
| 47 (34.8%) |
| 30 (22.2%) |
| 6 (4.4%) |
Prior vascular surgery | 60 (44.4%) |
| 44 (32.6%) |
| 20(14.8%) |
| 5 (3.6%) |
CAD | 59 (43.7%) |
Hypertension | 129 (95.6%) |
Stroke | 25 (18.5%) |
COPD | 43 (31.9%) |
Diabetes | 14 (10.4%) |
Smoking | 56 (41.5%) |
CKD | 53 (39.3%) |
| 40 (29.6%) |
| 13 (9.6%) |
Variable | Skeletal Muscle Index (SMI) | Total Psoas Muscle Index (TPMI) | ||||
---|---|---|---|---|---|---|
Sarcopenic (n = 45) | Non Sarcopenic (n = 90) | p-Value | Sarcopenic (n = 45) | Non Sarcopenic (n = 90) | p-Value | |
Male/Female ratio | 29 (64.4%)/16 (35.6%) | 57 (63.3%)/33 (36.7%) | 0.89 a | 29 (64.4%)/16 (35.6%) | 57 (63.3%)/33 (36.7%) | 0.89 a |
Mean patient age (y.o ± SD) | 70.9 ± 8.5 | 69.1 ± 8.7 | 0.3 b | 70.6 ± 10.2 | 69.2 ± 7.7 | 0.15 b |
BMI (kg/m2 ± SD) | 24.7 ± 4.2 | 28.1 ± 4.4 | 0.5 b | 24.9 ± 4.2 | 28 ± 4.4 | 0.39 b |
ASA grading | 0.92 a | 0.34 a | ||||
| 5 (11.1%) | 12 (13.3%) | 3 (6.7%) | 14 (15.6%) | ||
| 35 (77.8%) | 69 (76.7%) | 37 (82.2%) | 67 (74.4%) | ||
| 5 (11.1%) | 9 (10%) | 5 (11.1%) | 9 (10%) | ||
Type of TAAA | ||||||
| 1 (2.2%) | 7 (7.8%) | 0.19 c | 0 (0%) | 8 (8.9%) | 0.03c |
| 21 (46.7%) | 23 (25.6%) | 0.01a | 24 (53.3%) | 20 (22.2%) | <0.01a |
| 14 (31.1%) | 33 (36.7%) | 0.52 a | 13 (28.9%) | 34 (37.8%) | 0.3 a |
| 8 (17.8%) | 22 (24.4%) | 0.38 a | 7 (15.6%) | 23 (25.6%) | 0.18 a |
| 1 (2.2%) | 5 (5.6%) | 0.37 c | 1 (2.2%) | 5 (5.6%) | 0.37 c |
Prior vascular surgery | 24 (53.3%) | 36 (40%) | 0.14 a | 25 (55.6%) | 35 (38.9%) | 0.66 a |
| 18 (40%) | 26 (28.9%) | 0.19 a | 19 (42.2%) | 25 (27.8%) | 0.91 a |
| 8 (17.8%) | 12 (13.3%) | 0.49 a | 6 (13.3%) | 14 (15.6%) | 0.73 a |
| 1 (2.2%) | 4 (4.4%) | 0.51 | 1 (2.2%) | 4 (4.4%) | 0.51 |
CAD | 20 (44.4%) | 39 (43.3%) | 0.9 | 21 (46.7%) | 38 (42.2%) | 0.62 |
Hypertension | 44 (97.8%) | 85 (94.4%) | 0.37 | 44 (97.8%) | 85 (94.4%) | 0.37 |
Stroke | 11 (24.4%) | 14 (15.6%) | 0.21 | 11 (24.4%) | 14 (15.6%) | 0.21 |
COPD | 14 (31.1%) | 29 (32.2%) | 0.89 | 13 (28.9%) | 30 (33.3%) | 0.6 |
Diabetes | 6 (13.3%) | 8 (8.9%) | 0.42 | 4 (8.9%) | 10 (11.1%) | 0.69 |
Smoking | 15 (33.3%) | 41 (45.6%) | 0.17 | 15 (33.3%) | 41 (45.6%) | 0.17 |
CKD | 18 (40%) | 35 (38.9%) | 0.9 | 17 (37.8%) | 36 (40%) | 0.8 |
| 15 (33.3%) | 25 (27.8%) | 14 (31.1%) | 26 (28.9%) | ||
| 3 (6.7%) | 10 (11.1%) | 3 (6.7%) | 10 (11.1%) |
Skeletal Muscle Index HR 1.77, 95% CI 0.86–3.6, p = 0.11 | Total Psoas Muscle Index HR 0.82, 95% CI 0.43–1.56, p = 0.55 | |||||
---|---|---|---|---|---|---|
Variable | HR | 95% CI | p-Value | HR | 95% CI | p-Value |
Age | 1.07 | 1.02–1.12 | 0.003 | 1.08 | 1.02–1.12 | 0.003 |
Body mass index | 0.93 | 0.86–1 | 0.07 | 0.95 | 0.89–1.02 | 0.2 |
CAD | 0.73 | 0.37–1.43 | 0.36 | 0.7 | 0.36–1.34 | 0.28 |
COPD | 0.62 | 0.31–1.24 | 0.18 | 0.63 | 0.32–1.25 | 0.18 |
Diabetes | 0.95 | 0.32–2.84 | 0.93 | 1.03 | 0.35–3.07 | 0.94 |
Smoking | 0.94 | 0.48–1.83 | 0.86 | 0.87 | 0.45–1.71 | 0.7 |
CKD | 1.71 | 0.86–3.41 | 0.12 | 1.71 | 0.86–3.38 | 0.12 |
Skeletal Muscle Index | Total Psoas Muscle Index | ||||||
---|---|---|---|---|---|---|---|
Postoperative Complications | Total No. (%) | Sarcopenic (n = 45) | Non-Sarcopenic (n = 90) | p Value | Sarcopenic (n = 45) | Non-Sarcopenic (n = 90) | p Value |
MACE | 13 (9.6%) | 7 (15.6%) | 6 (6.7%) | 0.09 a | 6 (13.3%) | 7 (7.8%) | 0.3 a |
Pulmonal | 28 (20.7%) | 12 (26.7%) | 16 (17.8%) | 0.23 a | 14 (31.3%) | 14 (15.6%) | 0.03a |
AKI | 21 (15.6%) | 7 (15.6%) | 14 (15.6%) | 1 a | 9 (20%) | 12 (13.3%) | 0.45 a |
Hemodialysis | 10 (7.4%) | 4 (8.9%) | 6 (6.7%) | 0.64 b | 5 (11.1%) | 5 (5.6%) | 0.24 b |
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Sachsamanis, G.; Stahl, J.; Pfister, K.; Schierling, W.; Betz, T.; Jage, S. The Impact of Sarcopenia in the Long-Term Survival of Patients following Complex Endovascular Aortic Surgery for Thoracoabdominal Aortic Aneurysms. Diagnostics 2024, 14, 751. https://doi.org/10.3390/diagnostics14070751
Sachsamanis G, Stahl J, Pfister K, Schierling W, Betz T, Jage S. The Impact of Sarcopenia in the Long-Term Survival of Patients following Complex Endovascular Aortic Surgery for Thoracoabdominal Aortic Aneurysms. Diagnostics. 2024; 14(7):751. https://doi.org/10.3390/diagnostics14070751
Chicago/Turabian StyleSachsamanis, Georgios, Judith Stahl, Karin Pfister, Wilma Schierling, Thomas Betz, and Simon Jage. 2024. "The Impact of Sarcopenia in the Long-Term Survival of Patients following Complex Endovascular Aortic Surgery for Thoracoabdominal Aortic Aneurysms" Diagnostics 14, no. 7: 751. https://doi.org/10.3390/diagnostics14070751