TY - JOUR
T1 - Impact of Psoas Muscle Area Index on Short- and Mid-Term Mortality in Patients Undergoing Valve Surgery for Infective Endocarditis: A Retrospective Analysis
AU - Dinges, Christian
AU - Hammerer, Matthias
AU - Schörghofer, Nikolaos
AU - Knapitsch, Christoph
AU - Hecke, Gretha
AU - Klaus, Sophie
AU - Steindl, Johannes
AU - Rezar, Richard
AU - Seitelberger, Rainald
AU - Hoppe, Uta C.
AU - Hergan, Klaus
AU - Boxhammer, Elke
AU - Scharinger, Bernhard
N1 - Dinges, Steindl, Seitelberger: Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria; Hammerer, Rezar, Hoppe, Boxhammer: Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg,
5020 Salzburg, Austria; Schörghofer, Hecke, Klaus, Hergan, Scharinger: Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria;
Kommentar an die Editor*innen der Radiologie Sbg wegen der fehlenden PURE-Profile
PY - 2024/10/10
Y1 - 2024/10/10
N2 - Background: Sarcopenia, characterized by the loss of skeletal muscle mass, is an emerging comorbidity associated with poor outcomes in cardiovascular surgery. Its impact on mortality in patients undergoing valve surgery for infective endocarditis (IE) remains underexplored. This study investigates the relationship between sarcopenia, measured by the Psoas muscle area index (PMAi), and mortality in patients with IE undergoing valve surgery. Materials and Methods: We retrospectively analyzed 68 patients with IE who underwent valve surgery at a tertiary care center from 2013 to 2021. Sarcopenia was defined as being in the lowest quartile of PMAi, measured via preoperative computed tomography (CT). Baseline characteristics, survival outcomes, and factors influencing mortality were analyzed using Kaplan-Meier survival curves and Cox proportional hazards regression. The predictive value of PMAi for 1-year and 3-year mortality was assessed via receiver operating characteristic (ROC) curves. Results: Sarcopenia was strongly associated with increased mortality at both 1-year (HR: 0.378, p = 0.010) and 3-year follow-ups (HR: 0.457, p = 0.012). Female sex (OR: 275.748, p < 0.001) and older age (OR: 9.995, p = 0.003) were significant predictors of sarcopenia. Chronic kidney insufficiency (CKI) and the use of heart failure medication therapy also significantly impacted survival outcomes. Conclusions: Sarcopenia is a strong independent predictor of short- and mid-term mortality in patients undergoing valve surgery for IE. Routine radiological assessment of sarcopenia using PMAi could improve risk stratification and guide preoperative interventions. Tailored management strategies, especially in older women and patients with CKI, may enhance outcomes in this high-risk population.
AB - Background: Sarcopenia, characterized by the loss of skeletal muscle mass, is an emerging comorbidity associated with poor outcomes in cardiovascular surgery. Its impact on mortality in patients undergoing valve surgery for infective endocarditis (IE) remains underexplored. This study investigates the relationship between sarcopenia, measured by the Psoas muscle area index (PMAi), and mortality in patients with IE undergoing valve surgery. Materials and Methods: We retrospectively analyzed 68 patients with IE who underwent valve surgery at a tertiary care center from 2013 to 2021. Sarcopenia was defined as being in the lowest quartile of PMAi, measured via preoperative computed tomography (CT). Baseline characteristics, survival outcomes, and factors influencing mortality were analyzed using Kaplan-Meier survival curves and Cox proportional hazards regression. The predictive value of PMAi for 1-year and 3-year mortality was assessed via receiver operating characteristic (ROC) curves. Results: Sarcopenia was strongly associated with increased mortality at both 1-year (HR: 0.378, p = 0.010) and 3-year follow-ups (HR: 0.457, p = 0.012). Female sex (OR: 275.748, p < 0.001) and older age (OR: 9.995, p = 0.003) were significant predictors of sarcopenia. Chronic kidney insufficiency (CKI) and the use of heart failure medication therapy also significantly impacted survival outcomes. Conclusions: Sarcopenia is a strong independent predictor of short- and mid-term mortality in patients undergoing valve surgery for IE. Routine radiological assessment of sarcopenia using PMAi could improve risk stratification and guide preoperative interventions. Tailored management strategies, especially in older women and patients with CKI, may enhance outcomes in this high-risk population.
U2 - 10.3390/diagnostics14202259
DO - 10.3390/diagnostics14202259
M3 - Original Article
C2 - 39451582
SN - 2075-4418
VL - 14
JO - DIAGNOSTICS
JF - DIAGNOSTICS
IS - 20
M1 - 2259
ER -