Total psoas area predicts medium-term mortality after lower limb revascularization.

Area of Science:

• Vascular Surgery
• Perioperative Medicine
• Radiology

Background:

• Analytic morphometry, assessing core muscle mass, is a novel perioperative risk factor.
• Low muscle mass predicts frailty, complications, and mortality in various surgical fields.
• Its utility in lower limb revascularization requires investigation.

Purpose of the Study:

• To investigate the association between core muscle mass and outcomes after surgical lower limb revascularization.
• To determine if muscle mass predicts complication rates, hospital stay duration, and survival.

Main Methods:

• Retrospective cohort study of 263 patients undergoing lower limb revascularization (2013-2014).
• Total psoas area (TPA) measured from CT angiograms at L4 vertebral level.
• Cox and logistic regression analyses used to assess predictors of survival, complications, and hospital stay.

Main Results:

• American Society of Anesthesiologists score, emergency status, lowest TPA quartile, and Fontaine stage predicted survival.
• Lowest TPA quartile was an independent predictor of survival (HR, 1.89; P = .028).
• Low TPA was not associated with increased postoperative complications or prolonged hospital stay.

Conclusions:

• Psoas muscle area may identify patients with reduced life expectancy post-lower limb revascularization.
• The predictive role of psoas muscle area for postoperative complications or hospital admission length appears limited.