Analytic Morphomics, Core Muscle Size, and Surgical Outcomes

Englesbe, Michael J.; Lee, Jay S.; He, Kevin; Fan, Ludi; Schaubel, Douglas E.; Sheetz, Kyle H.; Harbaugh, Calista M.; Holcombe, Sven A.; Campbell, D.A.; Sonnenday, Christopher J.; Wang, Stewart C.

doi:10.1097/sla.0b013e31826028b1

Cited by 203 publications

(191 citation statements)

References 27 publications

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“…It leads to nosocomial infections [3], postoperative complications [4][5][6][7], increased length of hospital stay [7,8], and decreased survival in nonmalignant as well as malignant populations [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

et al. 2014

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Background Skeletal muscle loss is associated with physical disability, nosocomial infections, postoperative complications, and decreased survival. Preventing the loss of skeletal muscle mass after gastrectomy may lead to improved outcomes. The aims of this study were to assess changes in skeletal muscle mass after total gastrectomy (TG) and to clarify the clinical factors affecting significant loss of skeletal muscle after TG. Patients and methods One hundred and two patients undergoing TG for primary gastric cancer underwent abdominal computed tomography before and 1 year after TG to precisely quantify postoperative changes in skeletal muscle and adipose tissue. Univariate and multivariate logistic regression analyses identified clinical factors contributing to significant loss of skeletal muscle after TG.Results At 1 year after TG, the mass of both skeletal muscle and adipose tissue was reduced by 6.20 ± 6.80 and 65.8 ± 36.1 % of the preoperative values, respectively, and 26 patients (25.5 %) showed a significant loss of skeletal muscle of more than 10 %. Adjuvant chemotherapy with S-1 for C6 months (hazard ratio 26.61, 95 % confidence interval, 3.487-203.1) was identified as the single independent risk factor for a significant loss of skeletal muscle. Conclusions Skeletal muscle loss was exacerbated by extended adjuvant chemotherapy after TG. Further research should identify appropriate nutritional interventions for maintaining skeletal muscle mass and leading to improved outcomes.

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Section: Introductionmentioning

confidence: 99%

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

et al. 2014

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“…Morphometric analysis has proven utility in predicting postoperative morbidity and mortality following major general, vascular, and transplant surgery. 2,4,6,7,12,13,17,18,22,24,31 This study evaluates whether morphometrics can be used as a reliable predictor of perioperative morbidity in patients undergoing lumbar spine surgery.…”

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confidence: 99%

Morphometrics as a predictor of perioperative morbidity after lumbar spine surgery

Zakaria¹,

Schultz

Mossa-Basha

et al. 2015

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OBJECT Improved objective assessments of perioperative risk after spine surgery are necessary to decrease postoperative morbidity and mortality rates. Morphometric analysis has proven utility in predicting postoperative morbidity and mortality in surgical disciplines. The aim of the present study was to evaluate whether morphometrics can be applied to the cases of patients undergoing lumbar spine surgery. METHODS The authors performed a retrospective review of the perioperative course of 395 patients who underwent lumbar surgery at their institution from 2013 to 2014. Preoperative risk factors such as age, diabetes, smoking, coronary artery disease, and body mass index (BMI) were recorded. Preoperative MRI was used to measure the psoas muscle area at the L-4 vertebra and paraspinal muscle area at the T-12 vertebra. Primary outcomes included unplanned return to the operating room, 30- and 90-day readmissions, surgical site infection, wound dehiscence, new neurological deficit, deep vein thrombosis, pulmonary embolism, myocardial infarction, urinary tract infection, urinary retention, hospital-acquired pneumonia, stroke, and prolonged stay in the intensive care unit. RESULTS The overall rate of adverse events was 30%, the most common event being urinary retention (12%). Greater age (p = 0.015) and tobacco usage (p = 0.026) were both significantly associated with complications for all patients, while diabetes, coronary artery disease, and high BMI were not. No surgery-related characteristics were associated with postoperative morbidity, including whether surgery required instrumentation, whether it was a revision, or the number of vertebral levels treated. Using multivariate regression analysis, male and female patients with the lowest psoas tertile had an OR of 1.70 (95% CI 1.04–2.79, p = 0.035) for having postoperative complications. Male patients in the lowest psoas tertile had an OR of 2.42 (95% CI 1.17–5.01, p = 0.016) for having a postoperative complication. The paraspinal muscle groups did not provide any significant data for postoperative morbidity, even after multivariate analysis. CONCLUSIONS The morphometric measurement of psoas muscle size may be a sensitive predictive tool compared with other risk factors for perioperative morbidity in male patients undergoing lumbar surgery.

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“…This methodology, coined by us as "analytic morphomics" [18][19][20], provides additional objective information to assist radiologists during the interpretation of CT scans to make the diagnosis of cirrhosis. In clinical practice, it may be utilized to develop a CAD method to improve the sensitivity of cirrhosis diagnosis by radiologists.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Detection of Cirrhosis: Towards the Development of Computer-Assisted Detection Method

et al. 2014

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There are distinct morphologic features of cirrhosis on CT examinations; however, such impressions may be subtle or subjective. The purpose of this study is to build a computer-aided diagnosis (CAD) method to help radiologists with this diagnosis. One hundred sixty-seven abdominal CT examinations were randomly divided into training (n=88) and validation (n=79) sets. Livers were analyzed for morphological markers of cirrhosis and logistic regression models were created. Using the area under curve (AUC) for model performance, the best model had 0.89 for the training set and 0.85 for the validation set. For radiology reports, sensitivity of reporting cirrhosis was 0.45 and specificity 0.99. Using the predictive model adjunctively, radiologists' sensitivity increased to 0.63 and specificity slightly decreased to 0.97. This study demonstrates that quantifying morphological features in livers may be utilized for diagnosing cirrhosis and for developing a CAD method for it.

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Analytic Morphomics, Core Muscle Size, and Surgical Outcomes

Abstract: Core muscle size is an independent and potentially important preoperative risk factor. The techniques used to assess preoperative CT scans, namely analytic morphomics, may represent a novel approach to better understanding patient risk.

Cited by 203 publications

References 27 publications

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

Morphometrics as a predictor of perioperative morbidity after lumbar spine surgery

Quantitative Detection of Cirrhosis: Towards the Development of Computer-Assisted Detection Method

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