Original articleGeneral thoracicSarcopenia of the Psoas Muscles Is Associated With Poor Outcomes Following Lung Transplantation
Section snippets
Patient Population
We conducted a retrospective study of all patients who underwent either unilateral or bilateral orthotopic lung transplant at Johns Hopkins Hospital from January 2011 to December 2014. Patients were included in the study if they had an abdominal CT imaging within 6 months before operation as sarcopenia represents chronic muscle wasting. They were excluded from the study if they lacked relevant CT imaging, or had a CT that did not allow for analysis of the psoas muscles at the L4 level. Patient
Study Population
A total of 97 patients underwent orthotopic lung transplantation at Johns Hopkins over a 4-year period. Two patients were excluded from analysis due to lack of abdominal CT within 6 months before operation. Therefore, 95 patients met our inclusion criteria and had a median follow-up of 3.5 years. Patient demographic and comorbidity data are presented in Table 1. The mean age was 50.1 ± 15.2 years and 47 (49.5%) patients were women. Most patients were white (83.1%, n = 79) and the most common
Comment
Our study establishes statistically validated cutoffs for sarcopenia in lung transplant candidates based on indexed psoas muscle cross-sectional area determined by single-slice CT scan. We showed that SPM is significantly associated with death, diminished pulmonary function, any-grade BOS, and graft failure after lung transplantation. Additionally, our multivariate model of SPM exhibited a high degree of sensitivity and specificity for predicting mortality.
Previous studies have shown the
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2022, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Although various studies have described the significant impact of low BMI and small ESM mass (ESMCSA) on prognosis in patients with COPD25,26,37 and lung cancer,38,39 these factors were not associated with poor survival after LTx (Figure E5, Table 3). Although this finding is consistent with other studies in the literature, the relationship between preoperative small skeletal muscle mass and prognosis after LTx in previous studies has been controversial.11,21,22,40,41 Moreover, in our previous study, a low ESMCT preoperatively was associated with the recovery of ESMCSA.23
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Mr Hsu and Mr Krishnan contributed equally to this work.