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Age-dependent differences in the prognostic relevance of body composition-related variables in type A aortic
Zeng-Rong Luo1,2, Xiao-Dong Chen1,2, Liang-Wan Chen3,4
1Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.
Insights
Body mass index (BMI) and lean body mass (LBM) predict mortality in elderly patients with type A aortic dissection (TAAD). These body composition factors do not significantly predict outcomes in younger TAAD patients, highlighting age-specific risk assessment needs.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Medical Imaging
Background:
- Type A aortic dissection (TAAD) is a life-threatening condition requiring timely intervention.
- Understanding prognostic factors in TAAD is crucial for patient management and risk stratification.
- Body composition parameters may influence outcomes in cardiovascular diseases.
Purpose of the Study:
- To investigate the association between body composition parameters and mortality in type A aortic dissection (TAAD) patients.
- To determine if these associations differ between younger and elderly patient cohorts.
- To assess the prognostic value of body mass index (BMI), lean body mass (LBM), body surface area (BSA), and LBM index in TAAD.
Main Methods:
- Prospective data collection from 258 TAAD patients treated with a modified triple-branched stent-graft between 2017 and 2019.
- Cox proportional hazard regression analysis to evaluate correlations between body composition variables and cumulative mortality.
- Patients were stratified into young (<50 years) and elderly (≥50 years) groups.
Main Results:
- In the elderly group, increased BMI, BMI ≤ 18.5 kg/m², and lower LBM index were significant predictors of increased all-cause mortality.
- BMI showed a positive correlation with cumulative mortality in elderly TAAD patients but not in younger patients.
- Follow-up averaged 26.8 months for 247 survivors.
Conclusions:
- Body mass index (BMI) and lean body mass (LBM) index are significant predictors of all-cause mortality specifically in elderly TAAD patients.
- These body composition parameters lack significant prognostic value in younger TAAD patient cohorts.
- Age-specific risk stratification considering body composition is essential for managing TAAD patients.
Background:
The current research is allocated to appraise the association between the parameters of body composition and findings in type A aortic dissection (TAAD) cases in diverse age groups.
Methods:
Data from consecutive TAAD patients undergoing implantation of modified triple-branched stent-graft from January 2017 and December 2019 were prospectively collected and analyzed. A regression model of Cox proportional hazard was employed to assess correlations among body composition-related variables (body mass index [BMI], lean body mass [LBM], body surface area [BSA], and LBM index) as well as cumulative mortality.
Results:
Overall, 258 patients (53.9 ± 11.1 years old; 72.9% male) were separated into young (n = 110) and elderly (n = 148) age groups based upon whether they were younger or older than 50 years of age. Of these patients, 247 survivors were included in subsequent analyses over an average 26.8 ± 11.6 month follow-up duration. Multivariate analyses in the elderly group instead of young group indicated that increased BMI (p = 0.042), BMI ≤ 18.5 kg/m2 (p = 0.025), and lower LBM index values (p = 0.019) were significant predictors of increased total all-cause cumulative mortality. BMI was considerably positively correlated with estimated all-cause cumulative mortality in elderly but not young TAAD cases.
Conclusion:
Briefly, these results suggest that BMI and LBM indices are only significant predictors of TAAD patient all-cause mortality in elderly patient cohorts, whereas they do not offer significant prognostic value for younger patients. As such, these age differences must be taken into consideration when conducting stratified risk assessments based upon TAAD patient body composition characteristics.
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