title: Thoracic muscle cross-sectional area is associated with hospital length of stay post lung transplantation: a retrospective cohort study.
abstract: Low muscle mass is common in lung transplant (LTx) candidates; however, the clinical implications have not been well described. The study aims were to compare skeletal muscle mass in LTx candidates with controls using thoracic muscle cross-sectional area (CSA) from computed tomography and assess the association with pre- and post-transplant clinical outcomes. This was a retrospective, single-center cohort study of 527 LTx candidates [median age: 55 IQR (42-62) years; 54% male]. Thoracic muscle CSA was compared to an age- and sex-matched control group. Associations between muscle CSA and pre-transplant six-minute walk distance (6MWD), health-related quality of life (HRQL), delisting/mortality, and post-transplant hospital outcomes and one-year mortality were evaluated using multivariable regression analysis. Muscle CSA for LTx candidates was about 10% lower than controls (n = 38). Muscle CSA was associated with pre-transplant 6MWD, but not HRQL, delisting or pre- or post-transplant mortality. Muscle CSA (per 10 cm2difference) was associated with shorter hospital stay [0.7 median days 95% CI (0.2-1.3)], independent of 6MWD. In conclusion, thoracic muscle CSA is a simple, readily available estimate of skeletal muscle mass predictive of hospital length of stay, but further study is needed to evaluate the relative contribution of muscle mass versus functional deficits in LTx candidates.
authors.affiliation: Department of Medicine, Respirology, University of Toronto, Toronto, ON, Canada.|Lung Transplant Program, University Health Network, Toronto, ON, Canada.
authors.forename: Dmitry
authors.identifier: http://orcid.org/0000-0001-8786-9152
authors.initials: D
authors.lastname: Rozenberg
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
authors.forename: Sunita
authors.initials: S
authors.lastname: Mathur
authors.affiliation: Department of Medicine, Respirology, University of Toronto, Toronto, ON, Canada.|Critical Care, University Health Network, Toronto, ON, Canada.
authors.forename: Margaret
authors.initials: M
authors.lastname: Herridge
authors.affiliation: Department of Medicine, Respirology, University of Toronto, Toronto, ON, Canada.|Respirology, West Park Healthcare Center, Toronto, ON, Canada.
authors.forename: Roger
authors.initials: R
authors.lastname: Goldstein
authors.affiliation: Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
authors.forename: Heidi
authors.initials: H
authors.lastname: Schmidt
authors.affiliation: Lung Transplant Program, University Health Network, Toronto, ON, Canada.
authors.forename: Noori A
authors.initials: NA
authors.lastname: Chowdhury
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
authors.forename: Polyana
authors.initials: P
authors.lastname: Mendes
authors.affiliation: Department of Medicine, Respirology, University of Toronto, Toronto, ON, Canada.|Lung Transplant Program, University Health Network, Toronto, ON, Canada.
authors.forename: Lianne G
authors.initials: LG
authors.lastname: Singer
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000473:pathology*; D018579:Patient Selection; D011788:Quality of Life; D012189:Retrospective Studies; D055948:Sarcopenia / Q000473:pathology; D013909:Thorax / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: computed tomography; lung transplantation; muscle mass