Greenleaf Christopher E, Dobrila Julija, Podgorsek Blaz, Nader Martin Osorio, Nguyen Anh V D, Uppu Santosh, Li Wen
Houston Children's Heart Institute, Memorial Hermann Hospital, University of Texas Health McGovern Medical School, Houston, TX, USA.
Clinical and Translational Sciences, University of Texas Health McGovern Medical School, Houston, TX, USA.
Res Sq. 2025 Mar 27:rs.3.rs-6234626. doi: 10.21203/rs.3.rs-6234626/v1.
Thoracic sarcopenia, as shown by reduced thoracic skeletal muscle volume (TSMV) on imaging, predicts adverse outcomes after surgery in other patient populations. We sought to ascertain whether a decrease in the thoracic muscle volume serves as a prognostic indicator for postoperative morbidity and mortality in patients undergoing surgery for congenital cardiac anomalies.
All consecutive patients who underwent an index congenital cardiac operation were retrospectively analyzed. Chest cross-sectional imaging within 6 months preoperatively was identified. The TSMV was calculated at the T6 to T10 thoracic vertebrae level. Patients were stratified into high and low muscle groups using the median of muscle cross-sectional volume.
101 patients were included. Those with low TSMV were more likely to be less than one year old, had lower body weight, and had more preoperative comorbidities than those with high thoracic muscle volume. In univariate analysis, patients with low TSMV had a longer hospital length of stay (LOS) (10 vs. 7 days, p = 0.01) and more risk of hospital mortality (10.2% vs. 0%, p = 0.024). In the multivariable models, low thoracic volume showed no clear association with overall complications, cardiopulmonary complications, or intubation duration. Higher TSMV did predict a shorter LOS (MD per 10,000 mm increase: -70.7 days, CI -12.7 - -1.4, P = 0.01).
Our findings indicate that thoracic sarcopenia holds an association with LOS and mortality in patients undergoing surgery for congenital cardiac anomalies. As such, thoracic sarcopenia merits consideration as a potential risk factor in the preoperative assessment of patients presenting for congenital cardiac surgical interventions.
影像学显示胸段骨骼肌体积（TSMV）减少所提示的胸段肌肉减少症，可预测其他患者群体术后的不良结局。我们试图确定胸段肌肉体积的减少是否可作为先天性心脏畸形手术患者术后发病率和死亡率的预后指标。
对所有连续接受初次先天性心脏手术的患者进行回顾性分析。确定术前6个月内的胸部横断面影像。在胸6至胸10椎体水平计算TSMV。根据肌肉横断面体积的中位数将患者分为高肌肉组和低肌肉组。
纳入101例患者。TSMV低的患者比胸段肌肉体积高的患者更可能年龄小于1岁、体重更低且术前合并症更多。单因素分析中，TSMV低的患者住院时间更长（10天对7天，p = 0.01）且医院死亡风险更高（10.2%对0%，p = 0.024）。在多变量模型中，胸段体积低与总体并发症、心肺并发症或插管持续时间无明显关联。较高的TSMV确实可预测住院时间更短（每增加10,000 mm的平均差：-70.7天，CI -12.7 - -1.4，P = 0.01）。
我们的研究结果表明，胸段肌肉减少症与先天性心脏畸形手术患者的住院时间和死亡率相关。因此，在对接受先天性心脏手术干预的患者进行术前评估时，胸段肌肉减少症值得作为一个潜在风险因素加以考虑。
