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Scoping review of radiologic assessment and prognostic impact of skeletal muscle sarcopenia in patients undergoing endovascular repair for aortic disease
Integrated Univ Hosp Verona, Unit Vasc Surg, Verona, Italy..ORCID iD: 0000-0002-6284-1740
Univ Hosp Trieste ASUGI, Cardiovasc Dept, Div Vasc & Endovasc Surg, Str Fiume 447, I-34149 Trieste, Italy..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.ORCID iD: 0000-0002-4224-5351
Univ Florida, Div Vasc Surg & Endovasc Therapy, Gainesville, FL USA..
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2022 (English)In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 76, no 5, p. 1407-1416Article, review/survey (Refereed) Published
Abstract [en]

Objective: The primary objectives of our scoping review were to evaluate the methods used by research groups to assess the incidence of sarcopenia in patients with aortic disease and the extent of the evidence base that links sarcopenia to the survival of patients undergoing elective endovascular aortic repair and to identify the recurring themes or gaps in the literature to guide future research. Methods: A scoping review in accordance with the PRISMA (preferred reporting items for systematic reviews and metaanalyses) protocols extension for scoping reviews was performed. The available studies included those fully reported in English (last query, April 30, 2022). The following PICO question was used to build the search equation: "in patients with aortic disease [population] undergoing endovascular repair [intervention], what was the prevalence and prognosis of radiologically defined sarcopenia [comparison] on the short- and long-term outcomes?" Results: A total of 31 studies were considered relevant, and 18 were included in the present scoping review. In brief, 12 studies had focused on standard endovascular aneurysm repair (EVAR), 2 on thoracic EVAR, and 4 on complex EVAR. All but two studies were retrospective in design, and only one study had included patients from a multicenter database. Sarcopenia had generally been defined using the computed tomography angiography (CTA) findings of the cross-sectional area of the psoas muscle at L3 or L4, sometimes with normalization against the height. Overall, despite the heterogeneity in the methods used for its definition, sarcopenia was highly prevalent (range, 12.5%-67.6%). The patients with sarcopenia had had higher rates of mortality (ratio ranged from 2.28 [95% confidence interval, 1.35-3.84] to 6.34 [95% confidence interval, 3.37-10.0]) and adverse events (41% vs 16%; P = .020). Conclusions: Sarcopenia, as identified using computed tomography angiography-based measurements of the skeletal muscle mass, was prevalent among patients undergoing elective EVAR, thoracic EVAR, or complex EVAR. The presence of sarcopenia has been shown to have a negative prognostic impact, increasing the operative risk and has been linked to poorer long-term survival.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 76, no 5, p. 1407-1416
Keywords [en]
Aortic aneurysm, Aortic disease, Endovascular repair, Outcomes, Sarcopenia, Scoping review
National Category
Surgery
Identifiers
URN: urn:nbn:se:uu:diva-494797DOI: 10.1016/j.jvs.2022.05.005ISI: 000898710000012PubMedID: 35667604OAI: oai:DiVA.org:uu-494797DiVA, id: diva2:1729472
Available from: 2023-01-20 Created: 2023-01-20 Last updated: 2023-01-20Bibliographically approved

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Mani, Kevin

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