Age-dependent differences in the prognostic relevance of body composition-related variables in type A aortic dissection patients

Abstract

Background The current research is allocated to appraise the association between the parameters of body composition and findings in type A aortic dissection (TAAD) cases in diverse age groups. Methods Data from consecutive TAAD patients undergoing implantation of modified triple-branched stent-graft from January 2017 and December 2019 were prospectively collected and analyzed. A regression model of Cox proportional hazard was employed to assess correlations among body composition-related variables (body mass index [BMI], lean body mass [LBM], body surface area [BSA], and LBM index) as well as cumulative mortality. Results Overall, 258 patients (53.9 ± 11.1 years old; 72.9% male) were separated into young (n = 110) and elderly (n = 148) age groups based upon whether they were younger or older than 50 years of age. Of these patients, 247 survivors were included in subsequent analyses over an average 26.8 ± 11.6 month follow-up duration. Multivariate analyses in the elderly group instead of young group indicated that increased BMI (p = 0.042), BMI ≤ 18.5 kg/m2 (p = 0.025), and lower LBM index values (p = 0.019) were significant predictors of increased total all-cause cumulative mortality. BMI was considerably positively correlated with estimated all-cause cumulative mortality in elderly but not young TAAD cases. Conclusion Briefly, these results suggest that BMI and LBM indices are only significant predictors of TAAD patient all-cause mortality in elderly patient cohorts, whereas they do not offer significant prognostic value for younger patients. As such, these age differences must be taken into consideration when conducting stratified risk assessments based upon TAAD patient body composition characteristics.

Impact of body mass index on perioperative mortality of acute stanford type A aortic dissection: a systematic review and meta-analysis

“…Moreover, 2 independent retrospective cohort studies in Japan [ 7 , 8 ] and 1 in Italy [ 22 ] identified obesity (BMI ≥ 30.0) as a risk factor of in-hospital mortality in ATAAD patients who underwent surgical repairs (OR = 3.00, 95% CI: 1.40–6.20, OR = 3.16, 95% CI: 1.48–6.74, and OR = 2.14, 95% CI: 1.22–3.78). However, a retrospective cohort study conducted in Germany [ 9 ] and 2 in China [ 10 , 24 ] found no associations.…”