Original articleAdult cardiacPsoas Muscle Area and Length of Stay in Older Adults Undergoing Cardiac Operations
Section snippets
Study Design
This study was a post-hoc analysis of a prospective cohort assembled over a 5-year period ending in July 2015 encompassing patients who underwent cardiac surgical procedures at the Jewish General Hospital in Montreal, Quebec. Patients scheduled to undergo cardiac surgical procedures were approached and asked to complete a questionnaire and physical performance tests. Electronic medical records were reviewed to ascertain comorbid conditions, operative adverse events, vital status, and LOS. It
Results
The study population consisted of 82 patients with clinical CT scans performed before or shortly after cardiac surgical procedures (median −2 days, interquartile range 14 days). The baseline characteristics of the study cohort are shown in Table 1. The mean age at the time of operation was 69.2 ± 9.97 years, and the percentage of men was 71%. There were 45 (55%) isolated CABG and 37 (45%) valve surgical procedures with or without CABG. Thirty-five abdominal CT scans were available to measure
Comment
This study is the first to demonstrate that low PMA is associated with increased postoperative LOS after cardiac surgical procedures and that PMA adds incremental value above the STS-predicted risk of prolonged LOS. The combination of low PMA and low handgrip muscle strength achieved the greatest improvement in our risk prediction model. The magnitude of the effect can be approximated as an additional 2 days of LOS for every 1 centimeter-squared decrement in PMA. As a marker of frailty and
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2023, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Although most of the cited sarcopenia studies similarly measured the psoas muscle at the L4 level, there also were significant differences across these studies. For example, mean age was less than 70 years in some series7,8,20 but more than 75 years in others9,10,14,16,17; in our study, the median age was 69 years versus a median age of 67 years in our previous report of 3309 TAAA repairs,23 which might explain the overall higher complication rates we observed in this series. Any categorical division into sarcopenia/nonsarcopenia groups is arbitrary and depends on how sarcopenia is defined.