Thorac Cardiovasc Surg 2023; 71(S 01): S1-S72
DOI: 10.1055/s-0043-1761822
Tuesday, 14 February
Potpourri aus der Thorax-Herz-Gefäß-Chirurgie II

Assessment of Sarcopenia as Frailty Parameter in Patients Awaiting Cardiac Surgery

Authors

  • M. L. Laux

    1   Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland

  • C. Braun

    1   Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland

  • R. Ostovar

    1   Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland

  • F. Schröter

    1   Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland

  • J. Albes

    1   Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland
Further Information
  All articles of this category

Background: Frailty is gaining importance in cardiac surgery as a decisive parameter for selection of conventional or interventional surgery. Sarcopenia is one important frailty marker and usually measured with handgrip tests. Measurement of lumbar muscles in CT scans is also common.

Method: In this prospective observational study, all elective patients presenting for cardiac surgery were included and screened for frailty according to fried criteria, including handgrip strength. Where CT data were available, muscular measurements of musculus erector spinae at height of TH 10 were taken. Correlation was tested with Kendall's TAU.

Results: 250 patients were included preoperatively; mean age was 67 ± 9 years. 32.88% were classified as frail or prefrail. After forming two groups with patients that had normal or altered handgrip strength, we found differences in muscular size at both sides of vertebrae TH 10 (right: 17.14 ± 4.16 vs. 19.01 ± 4.56 cm2; p < 0.001), muscular density (right: 16.3 ± 18.29 vs. 24.81 ± 14.55 HE, p = 0.004). Handgrip correlated significantly with muscular size (τ = 0.38, p < 0.001) as well as muscular density (τ = 0.351, p < 0.001).

Handgrip strength also had a significant negative correlation with in-hospital-stay (τ = −0.202, p < 0.001) as well as days in intensive care (τ = −0.217, p < 0.001). CT data showed negative correlation to duration of intensive care stay (muscular mass right side τ = −0.111, p = 0.023, left side τ = −0.106, p = 0.03, muscular density right side τ = −0.126, p = 0.01, left side τ = −0.138, p = 0.005) and also to length of in hospital stay (muscular mass right side τ = −0.106, p = 0.027, left side τ = −0.111, p = 0.02) meaning lower handgrip, muscular size, and density resulted in longer stays.

Conclusion: As CT scans are more and more common as routine preoperative diagnostic in elderly cardiac patients, they can also be used to assess sarcopenia, which is part of the frailty syndrome: measurements can be used to predict length of intensive care and in hospital stay. Further analysis needs to be done to evaluate exact cut off values.



Publication History

Article published online:
28 January 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany