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Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation.
Am J Cardiol. 2017 Feb 01; 119(3):457-460.AJ

Abstract

Frailty is a powerful predictor of outcomes after transcatheter aortic valve implantation (TAVI). Sarcopenia as assessed by psoas muscle area (PMA) is a validated tool to assess frailty before surgical procedures. We evaluated PMA as a predictor of outcomes after TAVI in 152 consecutive patients who underwent this procedure at our institution from 2011 to 2014. Preoperative computed tomography scans were used to measure PMA, which then was indexed to body surface area. Outcomes evaluated included (1) early poor outcome (30 days mortality, stroke, dialysis, and prolonged ventilation), (2) 1-year mortality, and (3) high-resource utilization (length of stay >7 days, discharge to rehabilitation, or readmission within 30 days). Indexed PMA (odds ratio [OR] 3.19, confidence interval [CI] 1.30 to 7.83; p = 0.012) and age (OR 1.92, CI 1.87 to 1.98; p = 0.012) predicted early poor outcome. Society of Thoracic Surgeons score predicted 1-year mortality (hazard ratio 3.07, CI 1.93 to 6.23; p = 0.011). High-resource utilization was observed more frequently in patients with PMA less than the median (73% vs 51%, OR 2.65, CI 1.32 to 5.36; p = 0.006). In conclusion, indexed PMA predicts early poor outcome and high-resource utilization after TAVI.

Authors+Show Affiliations

Department of Cardiovascular Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.Department of Cardiovascular Medicine, St. Luke's University Health Network, Bethlehem, Pennsylvania.Oakland University William Beaumont School of Medicine, Rochester, Michigan.Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, Michigan.Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, Michigan.Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, Michigan.Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, Michigan.Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, Michigan. Electronic address: Ivan.Hanson@beaumont.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27931723

Citation

Garg, Lohit, et al. "Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation." The American Journal of Cardiology, vol. 119, no. 3, 2017, pp. 457-460.
Garg L, Agrawal S, Pew T, et al. Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation. Am J Cardiol. 2017;119(3):457-460.
Garg, L., Agrawal, S., Pew, T., Hanzel, G. S., Abbas, A. E., Gallagher, M. J., Shannon, F. L., & Hanson, I. D. (2017). Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation. The American Journal of Cardiology, 119(3), 457-460. https://doi.org/10.1016/j.amjcard.2016.10.019
Garg L, et al. Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation. Am J Cardiol. 2017 Feb 1;119(3):457-460. PubMed PMID: 27931723.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation. AU - Garg,Lohit, AU - Agrawal,Sahil, AU - Pew,Timothy, AU - Hanzel,George S, AU - Abbas,Amr E, AU - Gallagher,Michael J, AU - Shannon,Francis L, AU - Hanson,Ivan D, Y1 - 2016/11/01/ PY - 2016/08/17/received PY - 2016/10/10/revised PY - 2016/10/10/accepted PY - 2016/12/10/pubmed PY - 2017/5/26/medline PY - 2016/12/10/entrez SP - 457 EP - 460 JF - The American journal of cardiology JO - Am J Cardiol VL - 119 IS - 3 N2 - Frailty is a powerful predictor of outcomes after transcatheter aortic valve implantation (TAVI). Sarcopenia as assessed by psoas muscle area (PMA) is a validated tool to assess frailty before surgical procedures. We evaluated PMA as a predictor of outcomes after TAVI in 152 consecutive patients who underwent this procedure at our institution from 2011 to 2014. Preoperative computed tomography scans were used to measure PMA, which then was indexed to body surface area. Outcomes evaluated included (1) early poor outcome (30 days mortality, stroke, dialysis, and prolonged ventilation), (2) 1-year mortality, and (3) high-resource utilization (length of stay >7 days, discharge to rehabilitation, or readmission within 30 days). Indexed PMA (odds ratio [OR] 3.19, confidence interval [CI] 1.30 to 7.83; p = 0.012) and age (OR 1.92, CI 1.87 to 1.98; p = 0.012) predicted early poor outcome. Society of Thoracic Surgeons score predicted 1-year mortality (hazard ratio 3.07, CI 1.93 to 6.23; p = 0.011). High-resource utilization was observed more frequently in patients with PMA less than the median (73% vs 51%, OR 2.65, CI 1.32 to 5.36; p = 0.006). In conclusion, indexed PMA predicts early poor outcome and high-resource utilization after TAVI. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/27931723/Psoas_Muscle_Area_as_a_Predictor_of_Outcomes_in_Transcatheter_Aortic_Valve_Implantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(16)31730-1 DB - PRIME DP - Unbound Medicine ER -