Impact of sarcopenia on long-term mortality following endovascular aneurysm repair

Abstract

Sarcopenia, also known as a reduction of skeletal muscle mass, is a patient-specific risk factor for vascular and cancer patients. However, there are no data on abdominal aortic aneurysm (AAA) patients treated with endovascular aneurysm repair (EVAR) who have sarcopenia. To determine the impact of sarcopenia on mortality following EVAR, we retrospectively reviewed 200 patients treated with EVAR by estimating muscle mass on abdominal computed tomography (CT) scans. Mortality was analyzed according to its presence (n=25) or absence (n=175). Sarcopenia was more common in women than men (32.0% vs 9.7%; p=0.005). Patients with sarcopenia had an increased risk of mortality compared to those without (76% vs 48%; p=0.016). Of note, the overall mortality rate was 51% with a median follow up of 8.4 years (interquartile range, 5.3-11.7). In conclusion, the presence of sarcopenia on a CT scan is an important predictor of longterm mortality in patients treated for AAA with EVAR. Pending further study, these data suggest that sarcopenia may aid in pre-procedural long-term survival assessment of patients undergoing EVAR.

Influence of psoas muscle area on mortality following elective abdominal aortic aneurysm repair

“…In this study, TPMA was measured in preference to the total abdominal muscle area, as this measurement could be performed manually by tracing around the left and right psoas muscle after limited training, without the need for specialist software. Similar to previous findings, measurement of TPMA was reproducible, as demonstrated by the absence of intraobserver and interobserver differences.…”

The Impact of Frailty on Outcomes of Elderly Patients After Major Vascular Surgery: A Systematic Review and Meta-analysis

“…Limb Ischaemia Frailty Index. 25 Six single domain tools were used in 11 studies examining four areas: cognition, 7 function dependency, 32,33,38 central muscle mass, 10,11,36,37,39,40 and nutrition. 35 Six studies were conducted in patients who underwent major vascular surgery, 7,8,28,30,31,34 nine studies in patients with AAA, 11,12,14,27,33,36e39 and 10 studies in patients with LEAD.…”

Body composition, sarcopenia, and quality of life in patients with oesophageal cancer before resection surgery and at follow‐up: a cohort study

“…Pre-operative sarcopenia in particular has been suggested to be a risk factor for morbidity after major surgical procedures including surgery for gastric cancer [11][12][13] and pancreatic cancer, 14,15 as well as aortic aneurysm surgery. 16 In this study, although 90% of the patients had a working capacity that was lower than aged-matched healthy controls, 24 the incidence of sarcopenia was surprisingly low, only 20%. One interpretation of this could be that many patients in this cohort had maintained their muscle mass as reflected by the FFMI measures ( Table 1).…”

“…Several previous investigations highlight severe weight loss, malnourishment, and low performance as specific risk factors for post-operative complications in patients undergoing major surgery. 7,11,12,[14][15][16] We therefore raised the hypothesis that any of these parameters may predict increased risk for a negative outcome in this patient group. Subsequently, univariate logistic regression analyses of the biometric variables at baseline were made to establish if there was any single pre-operative variable that could predict complications.…”

“…14,15 A similar correlation is seen after major surgery for benign diagnoses, for example, sarcopenia is described as an independent risk factor for mortality in endovascular repair of aortic aneurysms. 16 Although oesophageal cancer is associated with restricted nutritional intake due to dysphagia and catabolic challenge, there is little available research on its physiological consequences. We have found only one retrospective Asian study that describes how body composition, sarcopenia, and other biometric measures manifest pre-operatively 9 ; however, no post-operative data during follow-up were reported.…”