The prevalence of sarcopaenia in a vascular surgical patient cohort and its impact on outcome.

BACKGROUND

Sarcopaenia, loss of lean muscle mass and quality, has prognostic significance and can be used to guide the management of oncology patients. However, there is limited research into the prevalence and effect of sarcopaenia in vascular populations. We aim to investigate the prevalence of this measure of physiological reserve in a vascular patient group.

METHODS

All patients admitted to a tertiary vascular unit in a single year were considered for the study. Patients with an abdominal CT scan (available for analysis) within 12 months of admission were included. Patient data were extracted from electronic patient records and hospital case notes. CT scans were analysed at L3 vertebral body to calculate body composition indices, as previously described. Sarcopaenia was defined as skeletal muscle index of <41 cm/m in female patients and non-obese males and <53 cm/m in obese males. Outcome at 3-years was ascertained.

RESULTS

Of 314 patients, 129 (41.1%) were sarcopaenic. Female patients were more likely to be sarcopaenic (p < 0.0001). The prevalence of sarcopaenia increased with age (p < 0.001). Rates of sarcopaenia didn't differ between occlusive and aneurysmal diagnoses. In a potentially unique finding in vascular literature to date, mortality and non-home discharge were not significantly different between the groups. On multivariate analysis, sarcopaenia was not significantly associated with earlier death (p = 0.55).

CONCLUSIONS

Sarcopaenia is highly prevalent in vascular surgical patients. In our analysis, sarcopaenia was not independently associated with mortality. Potentially the associated cardiovascular risk of patients with end stage vascular disease may negate the additional risk of altered body composition.