Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation.
The American journal of cardiology
Frailty is a powerful predictor of outcomes after transcatheter aortic valve implantation (TAVI). Sarcopenia as assessed by psoas muscle area (PMA) is a validated tool to assess frailty before surgical procedures. We evaluated PMA as a predictor of outcomes after TAVI in 152 consecutive patients who underwent this procedure at our institution from 2011 to 2014. Preoperative computed tomography scans were used to measure PMA, which then was indexed to body surface area. Outcomes evaluated included (1) early poor outcome (30 days mortality, stroke, dialysis, and prolonged ventilation), (2) 1-year mortality, and (3) high-resource utilization (length of stay >7 days, discharge to rehabilitation, or readmission within 30 days). Indexed PMA (odds ratio [OR] 3.19, confidence interval [CI] 1.30 to 7.83; p = 0.012) and age (OR 1.92, CI 1.87 to 1.98; p = 0.012) predicted early poor outcome. Society of Thoracic Surgeons score predicted 1-year mortality (hazard ratio 3.07, CI 1.93 to 6.23; p = 0.011). High-resource utilization was observed more frequently in patients with PMA less than the median (73% vs 51%, OR 2.65, CI 1.32 to 5.36; p = 0.006). In conclusion, indexed PMA predicts early poor outcome and high-resource utilization after TAVI.
Medical Subject Headings
Age Factors; Aged; Aged, 80 and over; Aortic Valve Stenosis; Cause of Death; Comorbidity; Female; Frail Elderly; Humans; Length of Stay; Male; Mortality; Odds Ratio; Organ Size; Patient Discharge; Patient Readmission; Prognosis; Proportional Hazards Models; Psoas Muscles; Rehabilitation Centers; Renal Dialysis; Renal Insufficiency; Respiration, Artificial; Sarcopenia; Stroke; Tomography, X-Ray Computed; Transcatheter Aortic Valve Replacement; Treatment Outcome
Garg L, Agrawal S, Pew T, Hanzel GS, Abbas AE, Gallagher MJ, Shannon FL, Hanson ID. Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation. Am J Cardiol. 2017 Feb 1;119(3):457-460. doi: 10.1016/j.amjcard.2016.10.019. Epub 2016 Nov 1. PubMed PMID: 27931723.