Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia; Notre Dame School of Medicine, Sydney, Australia; St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.
Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.
J Thorac Cardiovasc Surg. 2024 Mar;167(3):1115-1122.e5. doi: 10.1016/j.jtcvs.2022.07.005. Epub 2022 Jul 11.
We sought to evaluate the association of low rectus femoris cross-sectional area (RFCSA) with hospital length of stay and poorer outcomes in patients undergoing cardiac surgery.
A single right-leg RFCSA was measured with ultrasound preoperatively and baseline characteristics, clinical data, and outcomes recorded. Patients were categorized as low rectus femoris muscle size (lowRF) or normal rectus femoris muscle size (normalRF), if they were in the lowest quartile or not, respectively. All analyses were performed on both body surface area (BSA)- and sex-adjusted RFCSA.
One hundred eight-four patients had a RFCSA measured with a mean of 5.01 cm (1.41 cm), and range of 0.71 to 8.77 cm. When analyzing the BSA-adjusted RFCSA, we found the lowRF group had a longer hospital stay, 11.0 days [7.0-16.3] versus 8.0 days [6.0-10.0] for the normalRF group (P < .001), and a greater proportion of extended hospital stay (≥18.5 days) of 19.6% compared with 6.2% (P = .010). When the RFCSA was adjusted for sex, the lowRF group had a greater length of hospital stay, 9.0 days [7.0-14.5] versus 8.0 days [6.0-11.0] (P = .049). In both the BSA- and sex-adjusted RFCSA, the lowRF group suffered greater morbidity and were more likely discharged to a destination other than home. In multivariate analyses adjusting for European System for Cardiac Operative Risk Evaluation II, BSA-adjusted lowRF but not sex-adjusted lowRF was independently associated with log-transformed hospital length of stay. LowRF was not independently associated with increased major morbidity and death for both BSA and sex-adjusted RFCSA.
Low RFCSA has a significant association with increased hospital length of stay, morbidity, and nonhome discharge in patients undergoing cardiac procedures.
ACTRN12620000678998.
我们旨在评估股直肌横截面积（RFCSA）较低与接受心脏手术的患者住院时间延长和预后较差的相关性。
术前使用超声测量单侧右下肢 RFCSA，并记录基线特征、临床数据和结局。如果患者处于最低四分位数，则将其归类为股直肌小（lowRF）或正常股直肌大小（normalRF）。所有分析均在身体表面积（BSA）和性别调整后的 RFCSA 上进行。
1084 例患者的 RFCSA 进行了测量，平均值为 5.01cm（1.41cm），范围为 0.71 至 8.77cm。在分析 BSA 调整后的 RFCSA 时，我们发现 lowRF 组的住院时间更长，为 11.0 天[7.0-16.3]，而 normalRF 组为 8.0 天[6.0-10.0]（P<0.001），且延长住院时间（≥18.5 天）的比例为 19.6%，而 normalRF 组为 6.2%（P=0.010）。当 RFCSA 按性别调整时，lowRF 组的住院时间更长，为 9.0 天[7.0-14.5]，而 normalRF 组为 8.0 天[6.0-11.0]（P=0.049）。在 BSA 和性别调整后的 RFCSA 中，lowRF 组的发病率更高，且更有可能出院至非家庭目的地。在调整欧洲心脏手术风险评估系统 II 的多变量分析中，BSA 调整后的 lowRF 而不是性别调整后的 lowRF 与住院时间的对数呈独立相关。对于 BSA 和性别调整后的 RFCSA，lowRF 与主要发病率和死亡率的增加均无独立相关性。
在接受心脏手术的患者中，低 RFCSA 与住院时间延长、发病率和非家庭出院有显著相关性。
ACTRN12620000678998。
