Factors Affecting the Decrease in Psoas Muscle Area 1 Year After Thoracic Aortic Replacement in Older Patients

To investigate the rate of change in the psoas muscle area (PMA) from the preoperative period to 1 year postoperatively in patients aged ≥65 years undergoing elective thoracic aortic replacement and identify factors influencing PMA decrease at 1 year.

In this single-center retrospective study, PMA was measured in 73 patients (median age, 75 years; 25 women) preoperatively and 1 year postoperatively. Factors affecting PMA decreased after thoracic aortic replacement were identified using univariate and multivariate analyses. Patients were divided into 2 groups based on whether their PMA had decreased 1 year after thoracic aortic replacement compared to the preoperative value.

The decrease and nondecrease groups comprised 38 and 35 patients, respectively. From the univariate logistic regression analysis results, male sex (P = 0.004), preoperative body mass index (BMI) (P = 0.020), and failure of postoperative 6-min walk distance (6 MWD) to recover to the preoperative value (P = 0.012) were selected for the multivariate analysis. Multivariate logistic regression analysis identified male sex (odds ratio (OR) = 5.019, 95% confidence interval (CI) = 1.527-16.499, P = 0.008), preoperative BMI (OR = 1.190, 95% CI = 1.004-1.410, P = 0.045), and failure of postoperative 6 MWD to recover to the preoperative value (OR = 9.617, 95% CI = 1.590-58.152, P = 0.014) as independent predictors of PMA decrease.

Male sex, preoperative BMI, and failure of postoperative 6 MWD to recover to the preoperative value were independent factors influencing the decrease in PMA 1 year after thoracic aortic replacement.