Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan.
Surg Today. 2024 Jun;54(6):574-580. doi: 10.1007/s00595-023-02765-y. Epub 2023 Nov 20.
Some predictive markers of death have been reported for patients on the waiting list for lung transplantation (LTx). We assessed whether or not the preoperative psoas muscle index (PMI) correlates with waitlist mortality.
In 81 patients with end-stage lung disease on the waiting list for LTx between 2011 and 2020 at Osaka University Hospital, we examined the association between baseline characteristics, including the diagnosis, respiratory function test results, blood collection items, steroid use, and psoas muscle mass on computed tomography, and survival during the waiting period using Kaplan-Meier curves and Cox proportional hazard regression models.
Thirty-three patients (41%) died during follow-up. Univariate and multivariate analyses showed that patients with a low PMI had a higher rate of death during follow-up than those with a high PMI (p < 0.0001 and 0.0002, respectively). In addition, a diagnosis of interstitial pneumonia (hazard ratio 3.30, 95% confidence interval 1.52-7.17, p = 0.0025) and low albumin level (hazard ratio 2.21, 95% confidence interval 1.02-4.80, p = 0.0449) were also significant predictors of survival.
A low PMI at registration is associated with a decreased survival time among LTx candidates and it may be a predictive factor of mortality in patients waiting for LTx.
已有研究报道了肺移植（LTx）等待名单上患者死亡的一些预测标志物。本研究评估了术前竖脊肌指数（PMI）与等待名单死亡率之间是否存在相关性。
在 2011 年至 2020 年期间，在大阪大学医院登记的 81 名终末期肺病且等待 LTx 的患者中，我们检查了基线特征（包括诊断、呼吸功能测试结果、血液采集项目、皮质类固醇的使用情况以及 CT 上的竖脊肌质量）与等待期间生存情况之间的关系，使用 Kaplan-Meier 曲线和 Cox 比例风险回归模型进行分析。
33 名（41%）患者在随访期间死亡。单因素和多因素分析显示，PMI 较低的患者在随访期间的死亡率高于 PMI 较高的患者（p<0.0001 和 0.0002）。此外，间质性肺炎的诊断（风险比 3.30，95%置信区间 1.52-7.17，p=0.0025）和低白蛋白水平（风险比 2.21，95%置信区间 1.02-4.80，p=0.0449）也是生存的显著预测因素。
登记时的低 PMI 与 LTx 候选者的生存时间缩短相关，它可能是等待 LTx 患者死亡的预测因素。
