Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair
Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Re...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Joshua K. Kays [verfasserIn] Tiffany W. Liang [verfasserIn] Teresa A. Zimmers [verfasserIn] Daniel P. Milgrom [verfasserIn] Hamzah Abduljabar [verfasserIn] Andrew Young [verfasserIn] Bradford J. Kim [verfasserIn] Teresa M. Bell [verfasserIn] Andres Fajardo [verfasserIn] Michael P. Murphy [verfasserIn] Leonidas G. Koniaris [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
In: JCSM Clinical Reports - Wiley, 2020, 3(2018), 1, Seite 12 |
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| Übergeordnetes Werk: |
volume:3 ; year:2018 ; number:1 ; pages:12 |
| Links: |
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| DOI / URN: |
10.17987/jcsm-cr.v3i1.53 |
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| Katalog-ID: |
DOAJ085443980 |
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| 520 | |a Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. | ||
| 650 | 4 | |a Abdominal aortic aneurysm | |
| 650 | 4 | |a Sarcopenia | |
| 650 | 4 | |a Myosteatosis | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Survival | |
| 653 | 0 | |a Internal medicine | |
| 700 | 0 | |a Tiffany W. Liang |e verfasserin |4 aut | |
| 700 | 0 | |a Teresa A. Zimmers |e verfasserin |4 aut | |
| 700 | 0 | |a Daniel P. Milgrom |e verfasserin |4 aut | |
| 700 | 0 | |a Hamzah Abduljabar |e verfasserin |4 aut | |
| 700 | 0 | |a Andrew Young |e verfasserin |4 aut | |
| 700 | 0 | |a Bradford J. Kim |e verfasserin |4 aut | |
| 700 | 0 | |a Teresa M. Bell |e verfasserin |4 aut | |
| 700 | 0 | |a Andres Fajardo |e verfasserin |4 aut | |
| 700 | 0 | |a Michael P. Murphy |e verfasserin |4 aut | |
| 700 | 0 | |a Leonidas G. Koniaris |e verfasserin |4 aut | |
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10.17987/jcsm-cr.v3i1.53 doi (DE-627)DOAJ085443980 (DE-599)DOAJ92d9762d2d3e4832a40daa8897a634ac DE-627 ger DE-627 rakwb eng RC31-1245 Joshua K. Kays verfasserin aut Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. Abdominal aortic aneurysm Sarcopenia Myosteatosis Prognosis Survival Internal medicine Tiffany W. Liang verfasserin aut Teresa A. Zimmers verfasserin aut Daniel P. Milgrom verfasserin aut Hamzah Abduljabar verfasserin aut Andrew Young verfasserin aut Bradford J. Kim verfasserin aut Teresa M. Bell verfasserin aut Andres Fajardo verfasserin aut Michael P. Murphy verfasserin aut Leonidas G. Koniaris verfasserin aut In JCSM Clinical Reports Wiley, 2020 3(2018), 1, Seite 12 (DE-627)176064059X (DE-600)3072752-2 25213555 nnns volume:3 year:2018 number:1 pages:12 https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/article/92d9762d2d3e4832a40daa8897a634ac kostenfrei https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/toc/2521-3555 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 3 2018 1 12 |
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10.17987/jcsm-cr.v3i1.53 doi (DE-627)DOAJ085443980 (DE-599)DOAJ92d9762d2d3e4832a40daa8897a634ac DE-627 ger DE-627 rakwb eng RC31-1245 Joshua K. Kays verfasserin aut Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. Abdominal aortic aneurysm Sarcopenia Myosteatosis Prognosis Survival Internal medicine Tiffany W. Liang verfasserin aut Teresa A. Zimmers verfasserin aut Daniel P. Milgrom verfasserin aut Hamzah Abduljabar verfasserin aut Andrew Young verfasserin aut Bradford J. Kim verfasserin aut Teresa M. Bell verfasserin aut Andres Fajardo verfasserin aut Michael P. Murphy verfasserin aut Leonidas G. Koniaris verfasserin aut In JCSM Clinical Reports Wiley, 2020 3(2018), 1, Seite 12 (DE-627)176064059X (DE-600)3072752-2 25213555 nnns volume:3 year:2018 number:1 pages:12 https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/article/92d9762d2d3e4832a40daa8897a634ac kostenfrei https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/toc/2521-3555 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 3 2018 1 12 |
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10.17987/jcsm-cr.v3i1.53 doi (DE-627)DOAJ085443980 (DE-599)DOAJ92d9762d2d3e4832a40daa8897a634ac DE-627 ger DE-627 rakwb eng RC31-1245 Joshua K. Kays verfasserin aut Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. Abdominal aortic aneurysm Sarcopenia Myosteatosis Prognosis Survival Internal medicine Tiffany W. Liang verfasserin aut Teresa A. Zimmers verfasserin aut Daniel P. Milgrom verfasserin aut Hamzah Abduljabar verfasserin aut Andrew Young verfasserin aut Bradford J. Kim verfasserin aut Teresa M. Bell verfasserin aut Andres Fajardo verfasserin aut Michael P. Murphy verfasserin aut Leonidas G. Koniaris verfasserin aut In JCSM Clinical Reports Wiley, 2020 3(2018), 1, Seite 12 (DE-627)176064059X (DE-600)3072752-2 25213555 nnns volume:3 year:2018 number:1 pages:12 https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/article/92d9762d2d3e4832a40daa8897a634ac kostenfrei https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/toc/2521-3555 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 3 2018 1 12 |
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10.17987/jcsm-cr.v3i1.53 doi (DE-627)DOAJ085443980 (DE-599)DOAJ92d9762d2d3e4832a40daa8897a634ac DE-627 ger DE-627 rakwb eng RC31-1245 Joshua K. Kays verfasserin aut Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. Abdominal aortic aneurysm Sarcopenia Myosteatosis Prognosis Survival Internal medicine Tiffany W. Liang verfasserin aut Teresa A. Zimmers verfasserin aut Daniel P. Milgrom verfasserin aut Hamzah Abduljabar verfasserin aut Andrew Young verfasserin aut Bradford J. Kim verfasserin aut Teresa M. Bell verfasserin aut Andres Fajardo verfasserin aut Michael P. Murphy verfasserin aut Leonidas G. Koniaris verfasserin aut In JCSM Clinical Reports Wiley, 2020 3(2018), 1, Seite 12 (DE-627)176064059X (DE-600)3072752-2 25213555 nnns volume:3 year:2018 number:1 pages:12 https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/article/92d9762d2d3e4832a40daa8897a634ac kostenfrei https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/toc/2521-3555 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 3 2018 1 12 |
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10.17987/jcsm-cr.v3i1.53 doi (DE-627)DOAJ085443980 (DE-599)DOAJ92d9762d2d3e4832a40daa8897a634ac DE-627 ger DE-627 rakwb eng RC31-1245 Joshua K. Kays verfasserin aut Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. Abdominal aortic aneurysm Sarcopenia Myosteatosis Prognosis Survival Internal medicine Tiffany W. Liang verfasserin aut Teresa A. Zimmers verfasserin aut Daniel P. Milgrom verfasserin aut Hamzah Abduljabar verfasserin aut Andrew Young verfasserin aut Bradford J. Kim verfasserin aut Teresa M. Bell verfasserin aut Andres Fajardo verfasserin aut Michael P. Murphy verfasserin aut Leonidas G. Koniaris verfasserin aut In JCSM Clinical Reports Wiley, 2020 3(2018), 1, Seite 12 (DE-627)176064059X (DE-600)3072752-2 25213555 nnns volume:3 year:2018 number:1 pages:12 https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/article/92d9762d2d3e4832a40daa8897a634ac kostenfrei https://doi.org/10.17987/jcsm-cr.v3i1.53 kostenfrei https://doaj.org/toc/2521-3555 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 3 2018 1 12 |
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In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). 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RC31-1245 Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair Abdominal aortic aneurysm Sarcopenia Myosteatosis Prognosis Survival |
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Joshua K. Kays Tiffany W. Liang Teresa A. Zimmers Daniel P. Milgrom Hamzah Abduljabar Andrew Young Bradford J. Kim Teresa M. Bell Andres Fajardo Michael P. Murphy Leonidas G. Koniaris |
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Sarcopenia is a Significant Predictor of Mortality After Abdominal Aortic Aneurysm Repair |
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Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. |
| abstractGer |
Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. |
| abstract_unstemmed |
Abstract Aims Repair of abdominal aortic aneurysms (AAA) decreases the incidence of rupture and death. In cancer patients, sarcopenia has been associated with increased surgical complications and mortality. The impact of sarcopenia on survival after AAA repair has yet to be described. Methods and Results Patient demographic, laboratory, body composition measurements and survival data were obtained from patients undergoing AAA repair at the Indiana University medical campus over a 5‐year period. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Overall, 58.2% presented with sarcopenia. Sarcopenic patients were older (71.8±8.3 versus 66.8±8.1 years; p<0.001), had lower body mass index (BMI) (26.3±5.2 versus 31.5±5.9 kg/m2; p<0.001), higher rates of myosteatosis (84.4% versus 52.%; p<0.001), greater AAA diameter (60.6±14.0 versus 57.8±11.7 mm; p=0.016), higher Charlson Comorbidity Index (CCI) (32.3% versus 25.1% ≥6; p=0.034), and increased rates of rupture (8.2% versus 3.8%; p=0.047). Sarcopenic and nonsarcopenic patients had no difference in 30‐day morbidity (8.5% versus 8.5%; p=0.991) or mortality (3.7% versus 0.9%; p=0.07). Univariate analysis demonstrated age, sarcopenia, myosteatosis, CCI, and BMI to be associated with long‐term survival. There was no correlation between BMI and sarcopenia. Both sarcopenia and myosteatosis resulted in decreased one‐, three‐, and five‐year survivals compared to their counterparts. On multivariate analysis sarcopenia is independently associated with survival, conferring a 1.6‐fold increase in death (p=0.04). The combination of sarcopenia plus myosteatosis doubled the risk of death compared to sarcopenia alone. Conclusions This is the first study to demonstrate that over half of all patients undergoing AAA repair are sarcopenic, a condition associated with increased mortality. Sarcopenia with myosteatosis is associated with double the mortality of sarcopenia alone. CT scan, but not BMI, accurately identifies sarcopenia and myosteatosis. Defining the mechanisms through which sarcopenia contributes to late death after AAA repair is critical to developing novel interventions that may improve survival in this high risk population. |
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Tiffany W. Liang Teresa A. Zimmers Daniel P. Milgrom Hamzah Abduljabar Andrew Young Bradford J. Kim Teresa M. Bell Andres Fajardo Michael P. Murphy Leonidas G. Koniaris |
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