Usefulness of Psoas Muscle Area Determined by Computed Tomography to Predict Mortality or Prolonged Length of Hospital Stay in Patients Undergoing Left Ventricular Assist Device Implantation.
The purpose of this study is to examine the association of sarcopenia as measured by psoas muscle area and outcomes in patients undergoing left ventricular assist device (LVAD) implantation. We retrospectively examined 333 consecutive patients who underwent implantation of a HeartMate II LVAD at our institution from June 2008 to August 2013. Patients were included if they had a perioperative computed tomography that spanned the L3-L4 vertebrae. Sarcopenia was defined as having the lowest tertile psoas muscle area by gender. The primary end point was the composite of inpatient death or prolonged length of stay of >30 days. One hundred patients met inclusion criteria. The psoas muscle area cut-off values for the lowest tertiles were 12.0 cm2for men and 6.5 cm2for women, resulting in 32 sarcopenic patients (32%). The primary outcome of inpatient death or prolonged length of stay occurred in 81% of patients in the sarcopenic versus 60% in the nonsarcopenic group (p = 0.043). There was a trend toward prolonged length of stay in sarcopenic patients but no difference in overall mortality. This demonstrates that sarcopenia as measured by psoas muscle area is associated with increased composite length of stay and mortality after LVAD implantation and may serve as correlate for frailty.
Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
George A
GA
Heberton
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri.
Michael
M
Nassif
Division of Diagnostic Radiology, Washington University School of Medicine, St. Louis, Missouri.
Andrew
A
Bierhals
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri.
Eric
E
Novak
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri.
Shane J
SJ
LaRue
Cardiology Division, Baylor University Medical Center, Dallas, Texas.
Brian
B
Lima
Cardiology Division, Baylor University Medical Center, Dallas, Texas.
Shelley
S
Hall
Florida Hospital Transplant Institute, Florida Hospital, Orlando, Florida.
Scott
S
Silvestry
Cardiology Division, Baylor University Medical Center, Dallas, Texas. Electronic address: susan.joseph@baylorhealth.edu.
Susan M
SM
Joseph
D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016658:Psoas Muscles / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D055948:Sarcopenia / Q000150:complications* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed