Adverse Outcomes after Advanced EVAR in Patients with Sarcopaenia

Area of Science:

• Vascular Surgery
• Radiology
• Geriatric Medicine

Background:

• Advanced endovascular aneurysm repair (EVAR) techniques are increasingly used.
• Sarcopenia, indicated by low total psoas muscle area (tPMA), is a growing concern in elderly patients.
• Predictive markers for adverse outcomes after complex EVAR are needed.

Purpose of the Study:

• To evaluate total psoas muscle area (tPMA) as a predictor of adverse outcomes in patients undergoing advanced EVAR.
• To assess the association between low tPMA (sarcopenia) and mortality, complications, and length of stay post-EVAR.

Main Methods:

• Retrospective cohort study of 257 patients undergoing advanced EVAR.
• tPMA measured from CT scans; low tertile defined as sarcopenic.
• Logistic and Cox regression analyses used to assess tPMA's association with outcomes.

Main Results:

• Higher tPMA correlated with an 8% reduction in all-cause mortality per cm² increase.
• Low tPMA was associated with increased 30-day mortality and spinal cord ischemia (SCI).
• tPMA negatively correlated with hospital stay length and predicted discharge to rehabilitation.

Conclusions:

• Total psoas muscle area (tPMA) measurement is a valuable predictive tool for adverse outcomes after advanced EVAR.
• tPMA can help identify high-risk patients for targeted interventions.
• Further research could explore optimizing tPMA in patients undergoing EVAR.