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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Sarcopenia measured by tomography as a predictor of morbidity and mortality in t...
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Vol. 71. Issue 7.
Pages 522-529 (August - September 2024)
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Vol. 71. Issue 7.
Pages 522-529 (August - September 2024)
Original article
Sarcopenia measured by tomography as a predictor of morbidity and mortality in thoracic surgery, a retrospective cohort study
Sarcopenia medida por tomografía como predictor de morbimortalidad en cirugía torácica, una cohorte retrospectiva
V. Martínez Hurtadoa,
Corresponding author
valeria.martinez@udea.edu.co

Corresponding author.
, C.D. Ramírez Lujána, C.A. Pardo Peñab, F.D. Casas Arroyavec, A. Garcíad
a Sección de Anestesiología y Reanimación, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
b Departamento de Radiología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
c Sección de Anestesiología y Reanimación, Facultad de Medicina, Universidad de Antioquia; Hospital San Vicente Fundación, Medellín, Colombia
d Sección de Anestesiología y Reanimación, Facultad de Medicina, Universidad de Antioquia; Hospital Alma Máter de Antioquia; Hospital Pablo Tobón Uribe, Medellín, Colombia
Article information
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Tables (3)
Table 1. Clinical and demographic characteristics.
Table 2. Areas of the pectoralis and erector spinae muscles in patients presenting and not presenting study outcomes, and differences in means.
Table 3. Raw and adjusted association between height-adjusted muscle area, 30-day mortality, and postoperative pneumonia.
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Abstract
Background

Sarcopenia has been identified as a risk factor for perioperative adverse events. Several studies have shown that tomographic assessment of muscle mass can be an appropriate indicator of sarcopenia associated with morbidity and mortality. The aim of the study was to determine the association between height-adjusted area of ​​the pectoral and erector spinae muscles (haPMA and haESA) and perioperative morbidity and mortality in thoracic surgery.

Methods

Retrospective cohort study. Measurement of muscle areas was performed by tomography. The outcomes were 30-day mortality and postoperative morbidity. The discriminative capacity of the muscle areas was evaluated with an analysis of ROC curves and the Youden index was used to establish a cut-off point. The raw morbidity and mortality risk was determined and adjusted for potential confounders.

Results

A total of 509 patients taken to thoracic surgery were included. The incidence of 30-day mortality was 7.3%. An association was found between muscle areas and 30-day mortality and pneumonia, with adequate discriminative power for mortality (AUC 0.68 for haPMA and 0.67 for haESA). An haPMA less than 10 and haESA less than 8.5 cm2/m2 were identified as a risk factor for 30-day mortality with an adjusted OR of 2.34 (95%CI 1.03–5.15) and 2.22 (95%CI 1.10–6.04) respectively.

Conclusions

Sarcopenia, defined as low muscle area in the pectoral and erector spinae muscles, is associated with increased morbidity and mortality in patients undergoing thoracic surgery.

Keywords:
Sarcopenia
Tomography
Thoracic surgery
Mortality
Outcomes
Resumen
Antecedentes

La sarcopenia se ha identificado como factor de riesgo para eventos adversos perioperatorios. Varios estudios han demostrado que la valoración tomográfica de la masa muscular puede ser un indicador apropiado de sarcopenia asociado a morbimortalidad. El objetivo del estudio fue determinar la asociación entre el área de los músculos pectorales y erectores de la espina ajustados por talla (AaMP y AaMEE) y morbimortalidad perioperatoria en cirugía torácica.

Métodos

Estudio de cohortes retrospectivo. Se realizó medición de áreas musculares mediante tomografía. Los desenlaces fueron mortalidad a 30 días y morbilidad posoperatoria. Se evaluó la capacidad discriminativa de las áreas musculares con un análisis de curvas ROC y se empleó el índice de Youden para establecer un punto de corte. Se determinó el riesgo de morbimortalidad crudo y ajustado por potenciales confusores.

Resultados

Se incluyeron 509 pacientes llevados a cirugía torácica. La incidencia de mortalidad a 30 días fue del 7,3%. Se encontró una asociación entre las áreas musculares y mortalidad a 30 días y neumonía, con una capacidad discriminativa adecuada para mortalidad (AUC 0,68 para AaMP y 0,67 para AaMEE). Se identificó un AaMP menor a 10 y AaMEE menor a 8,5 cm2/m2 como factor de riesgo para mortalidad a 30 días con un OR ajustado de 2,34 (IC95% 1,03–5,15) y 2,22 (IC95% 1,10–6,04), respectivamente.

Conclusiones

La sarcopenia, definida como una baja área muscular en los músculos pectorales y erectores de la espina, se asocia a mayor morbimortalidad en los pacientes sometidos a cirugía torácica.

Palabras clave:
Sarcopenia
Tomografía
Cirugía torácica
Mortalidad
Resultados

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