Sarcopenia With Preoperative Computer Tomography Chest Muscle Mass Component Prognosticates Longer Hospital Stay Following Cardiac Surgery

Purpose: Sarcopenia, a comprehensive marker of frailty, is assessed by evaluating the combination of muscle function (MF) and muscle mass (MM). Herein, we aim to evaluate the prognostic implication of sarcopenia assessed by MF, and pre-defined MM from a routine preoperative chest computer tomography (CT), in patients undergoing cardiac surgery. Methodology: This study included 237 patients who underwent cardiac surgery with sternotomy and preoperative CT chest from 2019 to 2023 at Townsville University Hospital, Queensland, Australia. Measurement of Pectoralis Major area (PMA) dimensions from routine preoperative CT chest was performed. This was evaluated as the average attenuation of segmented left and right muscle. The sarcopenia cut-off value was defined as the lowest sex-specific quartile in PMA with the cut-off values for PMA of 1,045 mm2 and 609 mm2 for males and females, respectively. MF of the last 30 patients from the cohort were assessed with handgrip strength and five-time chair rise test, as per the Revised European Working Group of Sarcopenia in Older People 2 (EWGSOP). Intra- and postoperative outcomes up to 30 days, were collected. Results: Among the 30 patients assessed for their MF and MM, 10 patients were identified with sarcopenia from both pre-defined MF as well as our newly define MM. Sarcopenic patients required significantly longer hospitalisation (8.6±2.32 vs. 6.55±3.07 days; p=0.021). Logistic Regression Analysis confirmed that sarcopenia with the imaging cut-off values is associated with increased hospital length of stay (odds ratio [OR]=6.0, 95% confidence interval: 1.13–31.99, p=0.036). There was a trend towards longer intensive care unit (ICU) stays and increased postoperative complications in sarcopenic patients. Conclusions: In this pilot study, sarcopenia based on preoperative CT chest measurement of pectoralis muscle dimensions and EWGSOP defined muscle function may predict hospital length of stay after cardiac surgery. Further evaluation of sarcopenia with this simple measurement is warranted in larger cohort studies.

Heart, Lung and Circulation

Heart, Lung and Circulation

34

1443-9506

N/A

Supplement 1

2