Trunk Muscle Cross-Sectional Area as a Predictive Factor for Length of Postoperative Hospitalization after Surgical Aortic Valve Replacement

Ann Thorac Cardiovasc Surg. 2020 Jun 20;26(3):151-157. doi: 10.5761/atcs.oa.19-00261. Epub 2020 Jan 29.

Abstract

Purpose: We investigated the utility of trunk muscle cross-sectional area to predict length of hospitalization after surgical aortic valve replacement (AVR) for aortic stenosis (AS).

Methods: Adult AS patients who underwent isolated AVR at a single institution were studied. The cross-sectional area of the erector spinae muscles (ESM) at the first and second lumbar vertebrae and that of the psoas muscle (PM) at the third and fourth lumbar vertebrae were measured on preoperative computed tomography (CT). Each was indexed to body surface area. Risk factors for prolonged postoperative hospitalization (>3 weeks) were assessed using multivariate regression analyses.

Results: Of 56 patients (mean age 76 ± 9 years; 25 men), 20 (35.7%) patients required prolonged hospitalization. A smaller indexed ESM cross-sectional area at the first lumbar vertebra (per 1 cm/m2, odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.57-0.88, P <0.01) and lower preoperative serum albumin level (per 0.1 g/dL, OR = 0.83, 95% CI = 0.70-0.99, P <0.05) were shown as independent predictors. Indexed PM cross-sectional area was not statistically significant.

Conclusion: The cross-sectional area of the trunk muscles can be used to identify patients at risk for prolonged hospitalization after AVR for adult AS.

Keywords: aortic stenosis; aortic valve replacement; erector spinae muscles; psoas muscle; sarcopenia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / physiopathology
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery*
  • Back Muscles / diagnostic imaging*
  • Back Muscles / physiopathology
  • Body Composition
  • Female
  • Health Status
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Humans
  • Length of Stay*
  • Male
  • Predictive Value of Tests
  • Psoas Muscles / diagnostic imaging*
  • Psoas Muscles / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Sarcopenia / diagnostic imaging*
  • Sarcopenia / physiopathology
  • Time Factors
  • Tomography, X-Ray Computed*
  • Treatment Outcome