PDF(Pubmed)
Abstract：
UNASSIGNED: Sarcopenia has emerged as a comprehensive predictor of mortality in diseased populations. The aim of this study was to evaluate the prognostic and predictive value of psoas muscle thickness/height (PMTH) measurement in patients with acute type A aortic dissection (AAAD).
UNASSIGNED: A retrospective analysis of patients (from January 2020 to December 2020) who underwent AAAD surgery at our institution was conducted. PMTH, as a measure of sarcopenia, was measured by preoperative computed tomography. Patients were classified into two groups according to the cut-off value of PMTH. To balance potential bias, a 1:1 propensity score matching (PSM) with a caliper 0.05 was conducted.
UNASSIGNED: PSM analysis created 68 pairs of patients. In short-term outcomes, a lower PMTH value was strongly correlated with higher in-hospital mortality and renal failure. Receiver operating characteristic (ROC) analysis suggested that sarcopenia had good predictive capabilities in in-hospital mortality, with the area under curve (AUC) of 0.81 [95% confidence interval (CI): 0.64-0.97]. During a median follow-up of 37 months, 24 (19.4%) patients died, including 16 in low PMTH group and 8 in high PMTH group. Kaplan-Meier analysis indicated the sarcopenia significantly affected long-term survival [log-rank P=0.02; hazard ratio (HR) 2.53 (95% CI: 1.13-5.66)]. Multivariable Cox regression analysis revealed that sarcopenia was an independent predictor for decreased survival [HR 2.73 (95% CI: 1.15-8.78)].
UNASSIGNED: Sarcopenia defined from the PMTH may be a useful tool for predicting short- and long-term mortality in patients after AAAD surgery.
UNASSIGNED: A retrospective analysis of patients (from January 2020 to December 2020) who underwent AAAD surgery at our institution was conducted. PMTH, as a measure of sarcopenia, was measured by preoperative computed tomography. Patients were classified into two groups according to the cut-off value of PMTH. To balance potential bias, a 1:1 propensity score matching (PSM) with a caliper 0.05 was conducted.
UNASSIGNED: PSM analysis created 68 pairs of patients. In short-term outcomes, a lower PMTH value was strongly correlated with higher in-hospital mortality and renal failure. Receiver operating characteristic (ROC) analysis suggested that sarcopenia had good predictive capabilities in in-hospital mortality, with the area under curve (AUC) of 0.81 [95% confidence interval (CI): 0.64-0.97]. During a median follow-up of 37 months, 24 (19.4%) patients died, including 16 in low PMTH group and 8 in high PMTH group. Kaplan-Meier analysis indicated the sarcopenia significantly affected long-term survival [log-rank P=0.02; hazard ratio (HR) 2.53 (95% CI: 1.13-5.66)]. Multivariable Cox regression analysis revealed that sarcopenia was an independent predictor for decreased survival [HR 2.73 (95% CI: 1.15-8.78)].
UNASSIGNED: Sarcopenia defined from the PMTH may be a useful tool for predicting short- and long-term mortality in patients after AAAD surgery.
摘要：
■肌肉减少症已经成为患病人群死亡率的综合预测指标。这项研究的目的是评估急性A型主动脉夹层（AAAD）患者腰大肌厚度/高度（PMTH）测量的预后和预测价值。
■对在我们机构接受AAAD手术的患者（2020年1月至2020年12月）进行了回顾性分析。PMTH,作为测量肌肉减少症的指标,通过术前计算机断层扫描测量。根据PMTH的临界值将患者分为两组。为了平衡潜在的偏差，采用卡尺0.05进行1:1倾向评分匹配(PSM)。
■PSM分析创建了68对患者。在短期结果中，较低的PMTH值与较高的院内死亡率和肾衰竭密切相关.受试者工作特征（ROC）分析表明，肌少症对住院死亡率具有良好的预测能力，曲线下面积（AUC）为0.81[95%置信区间（CI）：0.64-0.97]。在37个月的中位随访中，24例（19.4%）患者死亡，其中低PMTH组16例，高PMTH组8例。Kaplan-Meier分析显示肌肉减少症显著影响长期生存[log-rankP=0.02;风险比(HR)2.53(95%CI:1.13-5.66)]。多变量Cox回归分析显示，少肌症是生存率降低的独立预测因子[HR2.73(95%CI:1.15-8.78)]。
■根据PMTH定义的肌肉减少症可能是预测AAAD手术后患者短期和长期死亡率的有用工具。
■对在我们机构接受AAAD手术的患者（2020年1月至2020年12月）进行了回顾性分析。PMTH,作为测量肌肉减少症的指标,通过术前计算机断层扫描测量。根据PMTH的临界值将患者分为两组。为了平衡潜在的偏差，采用卡尺0.05进行1:1倾向评分匹配(PSM)。
■PSM分析创建了68对患者。在短期结果中，较低的PMTH值与较高的院内死亡率和肾衰竭密切相关.受试者工作特征（ROC）分析表明，肌少症对住院死亡率具有良好的预测能力，曲线下面积（AUC）为0.81[95%置信区间（CI）：0.64-0.97]。在37个月的中位随访中，24例（19.4%）患者死亡，其中低PMTH组16例，高PMTH组8例。Kaplan-Meier分析显示肌肉减少症显著影响长期生存[log-rankP=0.02;风险比(HR)2.53(95%CI:1.13-5.66)]。多变量Cox回归分析显示，少肌症是生存率降低的独立预测因子[HR2.73(95%CI:1.15-8.78)]。
■根据PMTH定义的肌肉减少症可能是预测AAAD手术后患者短期和长期死亡率的有用工具。
