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肝移植中背侧肌群面积与手术结果

Dorsal muscle group area and surgical outcomes in liver transplantation.

作者信息

Lee Christopher S, Cron David C, Terjimanian Michael N, Canvasser Leah D, Mazurek Alyssa A, Vonfoerster Ellen, Tishberg Lindsay M, Underwood Patrick W, Chang Eric T, Wang Stewart C, Sonnenday Christopher J, Englesbe Michael J

机构信息

Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA; Department of Surgery, University of Michigan, Ann Arbor, MI, USA.

出版信息

Clin Transplant. 2014 Oct;28(10):1092-8. doi: 10.1111/ctr.12422. Epub 2014 Aug 11.

Abstract

INTRODUCTION

Better measures of liver transplant risk stratification are needed. Our previous work noted a strong relationship between psoas muscle area and survival following liver transplantation. The dorsal muscle group is easier to measure, but it is unclear if they are also correlated with surgical outcomes.

METHODS

Our study population included liver transplant recipients with a preoperative CT scan. Cross-sectional areas of the dorsal muscle group at the T12 vertebral level were measured. The primary outcomes for this study were one- and five-yr mortality and one-yr complications. The relationship between dorsal muscle group area and post-transplantation outcome was assessed using univariate and multivariate techniques.

RESULTS

Dorsal muscle group area measurements were strongly associated with psoas area (r = 0.72; p < 0.001). Postoperative outcome was observed from 325 patients. Multivariate logistic regression revealed dorsal muscle group area to be a significant predictor of one-yr mortality (odds ratio [OR] = 0.53, p = 0.001), five-yr mortality (OR = 0.53, p < 0.001), and one-yr complications (OR = 0.67, p = 0.007).

CONCLUSION

Larger dorsal muscle group muscle size is associated with improved post-transplantation outcomes. The muscle is easier to measure and may represent a clinically relevant postoperative risk factor.

摘要

引言

需要更好的肝移植风险分层测量方法。我们之前的研究指出腰大肌面积与肝移植后的生存率之间存在密切关系。背部肌肉群更容易测量,但尚不清楚它们是否也与手术结果相关。

方法

我们的研究人群包括术前进行过CT扫描的肝移植受者。测量了T12椎体水平的背部肌肉群的横截面积。本研究的主要结局是1年和5年死亡率以及1年并发症。使用单变量和多变量技术评估背部肌肉群面积与移植后结局之间的关系。

结果

背部肌肉群面积测量与腰大肌面积密切相关(r = 0.72;p < 0.001)。观察了325例患者的术后结局。多变量逻辑回归显示,背部肌肉群面积是1年死亡率(比值比[OR] = 0.53,p = 0.001)、5年死亡率(OR = 0.53,p < 0.001)和1年并发症(OR = 0.67,p = 0.007)的重要预测指标。

结论

更大的背部肌肉群尺寸与改善的移植后结局相关。该肌肉更容易测量,可能代表一个具有临床意义的术后风险因素。

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