Open AccessInfluence of psoas muscle area on mortality following elective abdominal aortic aneurysm repair
Author(s) -
Waduud M. A.,
Wood B.,
Keleabetswe P.,
Manning J.,
Linton E.,
Drozd M.,
Hammond C. J.,
Bailey M. A.,
Scott D. J. A.
Publication year - 2019
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.11074
Subject(s) - medicine , abdominal aortic aneurysm , endovascular aneurysm repair , hazard ratio , sarcopenia , aneurysm , prospective cohort study , confidence interval , surgery , abdominal surgery , proportional hazards model , aortic aneurysm , cohort , radiology
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.