• Br J Surg · Mar 2019

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

    • M A Waduud, B Wood, P Keleabetswe, J Manning, E Linton, M Drozd, C J Hammond, M A Bailey, ScottD J ADJALeeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK., and vascular surgeons and interventional radiologists at the Leeds Vascular Institute.
    • Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
    • Br J Surg. 2019 Mar 1; 106 (4): 367374367-374.

    BackgroundThe 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.MethodsTPMA 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.ResultsIn 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) cm2 per m2 ; 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).ConclusionTPMA is not a suitable risk stratification tool for patients undergoing effective intervention for AAA.© 2019 BJS Society Ltd. Published by John Wiley & Sons Ltd.

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