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A Comparison of Frailty Measures at Listing to Predict Outcomes After Lung Transplantation
- Source :
- The Annals of thoracic surgery. 109(1)
- Publication Year :
- 2019
-
Abstract
- Background Sarcopenia may be an important predictive factor of outcomes after lung transplantation (LTx). Serum albumin and the 6-minute walk distance (6MWD) have been shown to be a marker of LTx outcomes. We measured sarcopenia, albumin, and 6MWD in a cohort of LTx patients and analyzed the utility of these as markers of outcomes for LTx patients. Methods We retrospectively identified LTx recipients from 2013-2018 at our institution who underwent computed tomographic imaging during their listing evaluation. From that image, we measured skeletal muscle cross-sectional surface area at the third lumbar vertebral level, and sarcopenia was diagnosed by established cutoffs. Associations between sarcopenia, albumin, 6MWD, and survival, and hospital length of stay, complications, readmissions, and discharge destination were evaluated. Results Sarcopenia was found in 72% (95 of 132) of patients, 18% (24 of 131) of patients were hypoalbuminemic, and 41% had a low 6MWD. Survival was not associated with presence of sarcopenia (hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.46-2.42) or low 6MWD (HR, 0.86; 95% CI, 0.410-1.83). Hospital length of stay, complications, readmissions, and discharge destination were not influenced by sarcopenia or 6MWD. In contrast, hypoalbuminemia was independently associated with decreased survival (HR, 2.25; 95% CI, 1.04-4.85) and a higher grade of postoperative complications (P = .04). Conclusions Sarcopenia is prevalent in LTx patients. Neither sarcopenia nor 6MWD predicted mortality or short-term outcomes after LTx. This is in contrast to albumin levels, which were inversely associated with survival and complications. Albumin shows promise as an important predictor of mortality and short-term outcomes after LTx.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Sarcopenia
medicine.medical_treatment
Walk Test
030204 cardiovascular system & hematology
03 medical and health sciences
FEV1/FVC ratio
0302 clinical medicine
Postoperative Complications
Interquartile range
Internal medicine
Medicine
Lung transplantation
Humans
Hypoalbuminemia
Serum Albumin
Retrospective Studies
Frailty
business.industry
Hazard ratio
Retrospective cohort study
Middle Aged
musculoskeletal system
medicine.disease
Prognosis
Treatment Outcome
030228 respiratory system
Cohort
Surgery
Female
Cardiology and Cardiovascular Medicine
business
human activities
Lung Transplantation
Subjects
Details
- ISSN :
- 15526259 and 20132018
- Volume :
- 109
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The Annals of thoracic surgery
- Accession number :
- edsair.doi.dedup.....c252ae224dd560090e340bad554461bd