Abstract：
BACKGROUND: Sarcopenia has been purported to be a pre-operative risk factor that affects patient outcomes in oncological surgery, but no study as of yet has investigated the effect of sarcopenia in patients with spinal tumours. Psoas muscle measurements, including the psoas muscle index (PMI), are an objective way to determine sarcopenia.
OBJECTIVE: We investigated if PMI could predict post-operative outcomes (length of hospital stay and post-operative complications) in surgically treated spinal tumour patients in a multi-ethnic Asian population.
METHODS: We conducted a retrospective cohort study of patients with spinal tumours who underwent surgery at our tertiary institution from January 2016 to January 2020. PMI was measured on T2-weighted MRI sequences, at the middle of the L3 vertebral body and measurements were collected by 2 independent raters. The primary outcome was length of hospital stay (LOS), and the secondary outcome was post-operative complications. ROC curve was used to attain the cut-off value for PMI and the population was then stratified into 2 groups; sarcopenic if PMI was less than 1.22 and non-sarcopenic if the PMI value was more than or equal to 1.22. Multivariable linear regression was used for LOS, while multivariate logistic regression was used for complications.
RESULTS: 57 patients were included with a mean length of stay of 17.8 days (SD 25.1) and the total number of patients with complications were 20 (35.1 %). Mean LOS was significantly higher in the sarcopenic group compared to the non-sarcopenic group. Univariate analysis confirmed the association of lower psoas muscle index corresponding with longer lengths of stay and this was corroborated in a multivariable linear regression model. There were no significant associations between PMI and postoperative complications.
CONCLUSIONS: Lower PMI values were significantly associated with a longer LOS. PMI may be warranted for risk stratifying Asian spinal tumour patients undergoing surgery.
OBJECTIVE: We investigated if PMI could predict post-operative outcomes (length of hospital stay and post-operative complications) in surgically treated spinal tumour patients in a multi-ethnic Asian population.
METHODS: We conducted a retrospective cohort study of patients with spinal tumours who underwent surgery at our tertiary institution from January 2016 to January 2020. PMI was measured on T2-weighted MRI sequences, at the middle of the L3 vertebral body and measurements were collected by 2 independent raters. The primary outcome was length of hospital stay (LOS), and the secondary outcome was post-operative complications. ROC curve was used to attain the cut-off value for PMI and the population was then stratified into 2 groups; sarcopenic if PMI was less than 1.22 and non-sarcopenic if the PMI value was more than or equal to 1.22. Multivariable linear regression was used for LOS, while multivariate logistic regression was used for complications.
RESULTS: 57 patients were included with a mean length of stay of 17.8 days (SD 25.1) and the total number of patients with complications were 20 (35.1 %). Mean LOS was significantly higher in the sarcopenic group compared to the non-sarcopenic group. Univariate analysis confirmed the association of lower psoas muscle index corresponding with longer lengths of stay and this was corroborated in a multivariable linear regression model. There were no significant associations between PMI and postoperative complications.
CONCLUSIONS: Lower PMI values were significantly associated with a longer LOS. PMI may be warranted for risk stratifying Asian spinal tumour patients undergoing surgery.
摘要：
背景：肌肉减少症被认为是影响肿瘤外科手术患者预后的术前风险因素，但是到目前为止，还没有研究调查肌肉减少症对脊柱肿瘤患者的影响。腰大肌测量,包括腰大肌指数（PMI），是确定肌少症的客观方法。
目的：我们调查了在亚洲多种族人群中，PMI是否可以预测手术治疗的脊柱肿瘤患者的术后结局（住院时间和术后并发症）。
方法：我们对2016年1月至2020年1月在我们的三级机构接受手术的脊柱肿瘤患者进行了一项回顾性队列研究。PMI是在T2加权MRI序列上测量的，在L3椎体的中间，测量结果由2个独立的评估者收集。主要结果是住院时间（LOS），次要结局是术后并发症.使用ROC曲线获得PMI的临界值，然后将人群分为2组；如果PMI小于1.22，则减少肌节病，如果PMI值大于或等于1.22，则为非减少肌节病。多变量线性回归用于LOS，而并发症采用多因素logistic回归分析。
结果：纳入57例患者，平均住院时间为17.8天（SD25.1），有并发症的患者总数为20例（35.1％）。与非节肌组相比，节肌组的平均LOS显着更高。单变量分析证实了较低的腰大肌指数与较长的住院时间相关，这在多变量线性回归模型中得到了证实。PMI与术后并发症无显著相关性。
结论：较低的PMI值与较长的LOS显著相关。PMI对于接受手术的亚洲脊柱肿瘤患者的风险分层可能是必要的。
目的：我们调查了在亚洲多种族人群中，PMI是否可以预测手术治疗的脊柱肿瘤患者的术后结局（住院时间和术后并发症）。
方法：我们对2016年1月至2020年1月在我们的三级机构接受手术的脊柱肿瘤患者进行了一项回顾性队列研究。PMI是在T2加权MRI序列上测量的，在L3椎体的中间，测量结果由2个独立的评估者收集。主要结果是住院时间（LOS），次要结局是术后并发症.使用ROC曲线获得PMI的临界值，然后将人群分为2组；如果PMI小于1.22，则减少肌节病，如果PMI值大于或等于1.22，则为非减少肌节病。多变量线性回归用于LOS，而并发症采用多因素logistic回归分析。
结果：纳入57例患者，平均住院时间为17.8天（SD25.1），有并发症的患者总数为20例（35.1％）。与非节肌组相比，节肌组的平均LOS显着更高。单变量分析证实了较低的腰大肌指数与较长的住院时间相关，这在多变量线性回归模型中得到了证实。PMI与术后并发症无显著相关性。
结论：较低的PMI值与较长的LOS显著相关。PMI对于接受手术的亚洲脊柱肿瘤患者的风险分层可能是必要的。
