Shuta Ikeda1, Akio Kodama2, Yohei Kawai2, Takuya Tsuruoka2, Masayuki Sugimoto2, Kiyoaki Niimi2, Hiroshi Banno2, Kimihiro Komori2. 1. Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumachou, Showa-ku, Nagoya-City, Aichi, 466-8560, Japan. ikeda78@med.nagoya-u.ac.jp. 2. Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumachou, Showa-ku, Nagoya-City, Aichi, 466-8560, Japan.
Abstract
PURPOSE: Sarcopenia and malnutrition are often used as surrogates for frailty, which is predictive of poor prognosis after surgery. We investigated the effects of sarcopenia and malnutrition on mortality after endovascular aneurysm repair (EVAR). METHODS: The subjects of this study were patients who underwent EVAR at our hospital between June 2007 and December 2013, excluding those who underwent reintervention. The psoas muscle area at the L4 level was used as an indicator of sarcopenia. The Geriatric Nutritional Risk Index was used as an indicator of malnutrition. RESULTS: There were 324 patients included in the study, with a mean age of 78.1 years and a median follow-up period of 56.7 months. Multivariate analysis revealed that sarcopenia (HR, 1.79; p = .042) and malnutrition (HR, 1.78; p = .043) were independent prognostic factors. Patients with both factors were classified as the high-risk group and others were classified as the low-risk group. The survival rate was significantly lower in the high-risk group than in the low-risk groups (p < .001). Even after propensity score matching, the high-risk group had a significantly lower survival rate (p < .001). CONCLUSION: Both sarcopenia and malnutrition were associated with long-term mortality after EVAR. Patients with both indicators had a poor mid-term survival.
PURPOSE: Sarcopenia and malnutrition are often used as surrogates for frailty, which is predictive of poor prognosis after surgery. We investigated the effects of sarcopenia and malnutrition on mortality after endovascular aneurysm repair (EVAR). METHODS: The subjects of this study were patients who underwent EVAR at our hospital between June 2007 and December 2013, excluding those who underwent reintervention. The psoas muscle area at the L4 level was used as an indicator of sarcopenia. The Geriatric Nutritional Risk Index was used as an indicator of malnutrition. RESULTS: There were 324 patients included in the study, with a mean age of 78.1 years and a median follow-up period of 56.7 months. Multivariate analysis revealed that sarcopenia (HR, 1.79; p = .042) and malnutrition (HR, 1.78; p = .043) were independent prognostic factors. Patients with both factors were classified as the high-risk group and others were classified as the low-risk group. The survival rate was significantly lower in the high-risk group than in the low-risk groups (p < .001). Even after propensity score matching, the high-risk group had a significantly lower survival rate (p < .001). CONCLUSION: Both sarcopenia and malnutrition were associated with long-term mortality after EVAR. Patients with both indicators had a poor mid-term survival.
Authors: Caterina Beatrice Monti; Paolo Righini; Maria Chiara Bonanno; Davide Capra; Daniela Mazzaccaro; Matteo Giannetta; Gabriele Maria Nicolino; Giovanni Nano; Francesco Sardanelli; Massimiliano M Marrocco-Trischitta; Francesco Secchi Journal: J Clin Med Date: 2022-07-12 Impact factor: 4.964