title: Dorsal muscle group area and surgical outcomes in liver transplantation.
abstract: BACKGROUND
  Better measures of liver transplant risk stratification are needed. Our previous work noted a strong relationship between psoas muscle area and survival following liver transplantation. The dorsal muscle group is easier to measure, but it is unclear if they are also correlated with surgical outcomes.
  
  
  METHODS
  Our study population included liver transplant recipients with a preoperative CT scan. Cross-sectional areas of the dorsal muscle group at the T12 vertebral level were measured. The primary outcomes for this study were one- and five-yr mortality and one-yr complications. The relationship between dorsal muscle group area and post-transplantation outcome was assessed using univariate and multivariate techniques.
  
  
  RESULTS
  Dorsal muscle group area measurements were strongly associated with psoas area (r = 0.72; p < 0.001). Postoperative outcome was observed from 325 patients. Multivariate logistic regression revealed dorsal muscle group area to be a significant predictor of one-yr mortality (odds ratio [OR] = 0.53, p = 0.001), five-yr mortality (OR = 0.53, p < 0.001), and one-yr complications (OR = 0.67, p = 0.007).
  
  
  CONCLUSIONS
  Larger dorsal muscle group muscle size is associated with improved post-transplantation outcomes. The muscle is easier to measure and may represent a clinically relevant postoperative risk factor.
authors.affiliation: Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA; Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Lee
authors.forename: David C
authors.initials: DC
authors.lastname: Cron
authors.forename: Michael N
authors.initials: MN
authors.lastname: Terjimanian
authors.forename: Leah D
authors.initials: LD
authors.lastname: Canvasser
authors.forename: Alyssa A
authors.initials: AA
authors.lastname: Mazurek
authors.forename: Ellen
authors.initials: E
authors.lastname: Vonfoerster
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Tishberg
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Underwood
authors.forename: Eric T
authors.initials: ET
authors.lastname: Chang
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Wang
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Sonnenday
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Englesbe
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D016658:Psoas Muscles / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: dorsal muscle group; end-stage liver disease; liver transplant; morphometric measure; psoas muscle; risk stratification; sarcopenia; surgical outcome