Sarcopenia measured by tomography as a predictor of morbidity and mortality in thoracic surgery, a retrospective cohort study

• Published in: Revista española de anestesiología y reanimación (English ed.) 2024-08, Vol.71 (7), p.522-529
• Main Authors: Martínez Hurtado, V., Ramírez Luján, C.D., Pardo Peña, C.A., Casas Arroyave, F.D., García, A.
• Format: Article
• Language: English
• Subjects: Cirugía torácica; Mortalidad; Mortality; Outcomes; Resultados; Sarcopenia; Thoracic surgery; Tomografía; Tomography
• ISSN: 2341-1929; 2341-1929
• DOI: 10.1016/j.redare.2024.05.001

Sarcopenia has been identified as a risk factor for perioperative adverse events. Several studies have shown that tomographic assessment of muscle mass can be an appropriate indicator of sarcopenia associated with morbidity and mortality. The aim of the study was to determine the association between height-adjusted area of ​​the pectoral and erector spinae muscles (haPMA and haESA) and perioperative morbidity and mortality in thoracic surgery. Retrospective cohort study. Measurement of muscle areas was performed by tomography. The outcomes were 30-day mortality and postoperative morbidity. The discriminative capacity of the muscle areas was evaluated with an analysis of ROC curves and the Youden index was used to establish a cut-off point. The raw morbidity and mortality risk was determined and adjusted for potential confounders. A total of 509 patients taken to thoracic surgery were included. The incidence of 30-day mortality was 7.3%. An association was found between muscle areas and 30-day mortality and pneumonia, with adequate discriminative power for mortality (AUC 0.68 for haPMA and 0.67 for haESA). An haPMA less than 10 and haESA less than 8.5 cm2/m2 were identified as a risk factor for 30-day mortality with an adjusted OR of 2.34 (95%CI 1.03–5.15) and 2.22 (95%CI 1.10–6.04) respectively. Sarcopenia, defined as low muscle area in the pectoral and erector spinae muscles, is associated with increased morbidity and mortality in patients undergoing thoracic surgery. La sarcopenia se ha identificado como factor de riesgo para eventos adversos perioperatorios. Varios estudios han demostrado que la valoración tomográfica de la masa muscular puede ser un indicador apropiado de sarcopenia asociado a morbimortalidad. El objetivo del estudio fue determinar la asociación entre el área de los músculos pectorales y erectores de la espina ajustados por talla (AaMP y AaMEE) y morbimortalidad perioperatoria en cirugía torácica. Estudio de cohortes retrospectivo. Se realizó medición de áreas musculares mediante tomografía. Los desenlaces fueron mortalidad a 30 días y morbilidad posoperatoria. Se evaluó la capacidad discriminativa de las áreas musculares con un análisis de curvas ROC y se empleó el índice de Youden para establecer un punto de corte. Se determinó el riesgo de morbimortalidad crudo y ajustado por potenciales confusores. Se incluyeron 509 pacientes llevados a cirugía torácica. La incidencia de mortalidad a 30 días fue del 7,3%. Se encontró una asociación