Preoperative sarcopenia and malnutrition are correlated with poor long-term survival after endovascular abdominal aortic aneurysm repair
Preoperative sarcopenia and malnutrition are correlated with poor long-term survival after endovascular abdominal aortic aneurysm repair
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DOI：
10.1007/s00595-021-02362-x
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发表时间：
2021-09-03
期刊：
影响因子：
2.5
通讯作者：
Komori, Kimihiro
中科院分区：
文献类型：
--
作者：
Ikeda, Shuta;Kodama, Akio;Komori, Kimihiro
目的肌少症和营养不良常被用来代替虚弱，预示着术后预后不良。我们研究了血管内动脉瘤修复（EVAR）后肌肉减少和营养不良对死亡率的影响。方法本研究对象为2007年6月至2013年12月在我院行EVAR的患者，不包括再干预患者。腰4水平腰肌面积作为肌少症的指标。使用老年营养风险指数作为营养不良的指标。结果共纳入324例患者，平均年龄78.1岁，中位随访时间56.7个月。多因素分析显示，肌肉减少症（HR, 1.79, p = 0.042）和营养不良（HR, 1.78, p = 0.043）是独立的预后因素。同时存在上述两种因素的患者被归为高危组，其他患者被归为低危组。高危组生存率明显低于低危组（p < 0.001）。即使在倾向评分匹配后，高危组的生存率也明显较低（p < 0.001）。结论肌少症和营养不良与EVAR术后长期死亡率相关。两项指标均达标的患者中期生存率较差。
Purpose Sarcopenia and malnutrition are often used as surrogates for frailty, which is predictive of poor prognosis after surgery. We investigated the effects of sarcopenia and malnutrition on mortality after endovascular aneurysm repair (EVAR). Methods The subjects of this study were patients who underwent EVAR at our hospital between June 2007 and December 2013, excluding those who underwent reintervention. The psoas muscle area at the L4 level was used as an indicator of sarcopenia. The Geriatric Nutritional Risk Index was used as an indicator of malnutrition. Results There were 324 patients included in the study, with a mean age of 78.1 years and a median follow-up period of 56.7 months. Multivariate analysis revealed that sarcopenia (HR, 1.79; p = .042) and malnutrition (HR, 1.78; p = .043) were independent prognostic factors. Patients with both factors were classified as the high-risk group and others were classified as the low-risk group. The survival rate was significantly lower in the high-risk group than in the low-risk groups (p < .001). Even after propensity score matching, the high-risk group had a significantly lower survival rate (p < .001). Conclusion Both sarcopenia and malnutrition were associated with long-term mortality after EVAR. Patients with both indicators had a poor mid-term survival.