Thoracic sarcopenia predicts clinical outcomes in patients undergoing coronary artery bypass grafting: A 6-year cohort study

被引:12
作者
Shen, Zi-Le
Liu, Zhang [1 ,2 ]
Zang, Wang-Fu [2 ]
Zhang, Peng [2 ]
Zou, Hong-Bo [1 ,4 ]
Dong, Wen-Xi [3 ]
Chen, Wen-Hao [3 ]
Yan, Xia-Lin [1 ,5 ]
Yu, Zhen [1 ,3 ,5 ]
机构
[1] Tongji Univ, Shanghai Peoples Hosp 10, Sch Med, Dept Gastrointestinal Surg, Shanghai, Peoples R China
[2] Tongji Univ, Shanghai Peoples Hosp 10, Sch Med, Dept Cardiothorac Surg, Shanghai, Peoples R China
[3] Wenzhou Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, Wenzhou, Peoples R China
[4] Peoples Hosp Deyang City, Dept Gastrointestinal Surg, Deyang, Sichuan, Peoples R China
[5] Tongji Univ, Shanghai Peoples Hosp 10, Sch Med, Dept Gastrointestinal Surg, Middle 301 Yanchang Rd, Shanghai 200072, Peoples R China
基金
中国国家自然科学基金;
关键词
Clinical outcomes; Coronary artery bypass grafting; Skeletal muscle index; Thoracic sarcopenia; CARDIAC-SURGERY; RADICAL GASTRECTOMY; MUSCLE; MORTALITY; IMPACT; MALNUTRITION; COMPLICATIONS;
D O I
10.1016/j.asjsur.2022.03.096
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The relationship between thoracic sarcopenia and clinical outcomes in patients underwent coronary artery bypass grafting (CABG) is unclear. This study aims to evaluate whether thoracic sarcopenia has a satisfactory prognostic effect on adverse outcomes after CABG.Methods: From December 2015 to May 2021, 338 patients who underwent isolated CABG at our institution were recruited in this study. Skeletal muscle area at T12 level acquired by chest computed tomography (CT) was normalized to assess thoracic sarcopenia. Univariate and multivariate analyses were performed to evaluate the risk factors of postoperative complications and overall survival (OS).Results: The prevalence of thoracic sarcopenia in patients underwent CABG was 13.02%. The incidence of total major complication was significantly higher in thoracic sarcopenia group (81.8% vs 61.9%, p = 0.010). Thoracic sarcopenic patients also had longer postoperative hospital stays (p = 0.047), intensive care unit (ICU) stays (p = 0.001), higher costs (p = 0.001) and readmission rates within 30 days of discharge (18.2% vs 4.4%, p = 0.001). Patients without thoracic sarcopenia showed significantly higher OS at the 2-year follow-up period (93.9% vs 72.7%, p<0.001). Multivariate analyses demonstrated that thoracic sarcopenia was significantly and independently associated with postoperative complications and long-term OS after CABG.Conclusion: Thoracic sarcopenia is an effective clinical predictor of adverse postoperative complications and long-term OS in patients underwent CABG. Thoracic sarcopenia based on chest CT should be included in preoperative risk assessment of CABG.(c) 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.
引用
收藏
页码:291 / 298
页数:8
相关论文
共 38 条
[1]   Electrophysiologic techniques for the assessment of respiratory muscle function [J].
Aldrich, TK ;
Sinderby, C ;
McKenzie, DK ;
Estenne, M ;
Gandevia, SC .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2002, 166 (04) :548-+
[2]   Isolated systolic hypertension is associated with adverse outcomes from coronary artery bypass grafting surgery [J].
Aronson, S ;
Boisvert, D ;
Lapp, W .
ANESTHESIA AND ANALGESIA, 2002, 94 (05) :1079-1084
[3]   Pulmonary function, muscle strength and mortality in old age [J].
Buchman, A. S. ;
Boyle, P. A. ;
Wilson, R. S. ;
Gu, Liping ;
Bienias, Julia L. ;
Bennett, D. A. .
MECHANISMS OF AGEING AND DEVELOPMENT, 2008, 129 (11) :625-631
[4]   Paraspinous muscle as a predictor of surgical outcome [J].
Canvasser, Leah D. ;
Mazurek, Alyssa A. ;
Cron, David C. ;
Terjimanian, Michael N. ;
Chang, Eric T. ;
Lee, Chris S. ;
Alameddine, Mitchell B. ;
Claflin, Jake ;
Davis, Elyse D. ;
Schumacher, Tucker M. ;
Wang, Stewart C. ;
Englesbe, Michael J. .
JOURNAL OF SURGICAL RESEARCH, 2014, 192 (01) :76-81
[5]  
Cederholm T, 2019, CLIN NUTR, V38, P1480, DOI [10.1016/j.clnu.2018.08.002, 10.1016/j.clnu.2019.02.033, 10.1002/jcsm.12383, 10.1002/jpen.1440]
[6]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[7]   Effectiveness of a perioperative pulmonary rehabilitation program following coronary artery bypass graft surgery in patients with and without COPD [J].
Chen, Jui-O ;
Liu, Jui-Fang ;
Liu, Yu-qi ;
Chen, Yu-Mu ;
Tu, Mei-Lien ;
Yu, Hong-Ren ;
Lin, Meng-Chih ;
Lin, Chiu-Chu ;
Liu, Shih-Feng .
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 2018, 13 :1591-1597
[8]   Sarcopenia is an effective prognostic indicator of postoperative outcomes in laparoscopic-assisted gastrectomy [J].
Chen, Xi-Yi ;
Li, Bo ;
Ma, Bing-Wei ;
Zhang, Xian-Zhong ;
Chen, Wei-Zhe ;
Lu, Lie-Sheng ;
Shen, Xian ;
Zhuang, Cheng-Le ;
Yu, Zhen .
EJSO, 2019, 45 (06) :1092-1098
[9]   Malnutrition in cardiac surgery: food for thought [J].
Chermesh, Irit ;
Hajos, Jonathan ;
Mashiach, Tatiana ;
Bozhko, Masha ;
Shani, Liran ;
Nir, Rony-Reuven ;
Bolotin, Gil .
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 2014, 21 (04) :475-483
[10]   The Clavien-Dindo Classification of Surgical Complications Five-Year Experience [J].
Clavien, Pierre A. ;
Barkun, Jeffrey ;
de Oliveira, Michelle L. ;
Vauthey, Jean Nicolas ;
Dindo, Daniel ;
Schulick, Richard D. ;
de Santibanes, Eduardo ;
Pekolj, Juan ;
Slankamenac, Ksenija ;
Bassi, Claudio ;
Graf, Rolf ;
Vonlanthen, Rene ;
Padbury, Robert ;
Cameron, John L. ;
Makuuchi, Masatoshi .
ANNALS OF SURGERY, 2009, 250 (02) :187-196