Effect Of Sarcopenia In Off Pump Coronary Bypass Surgery
Yoshihiro Goto, Soh Hosoba, Yuichiro Fukumoto, satoshi sumino, Yasuhide okawa.
Toyohashi heart center, Toyohashi, Japan.
BACKGROUND: Sarcopenia, low skeletal muscle status, is an objective marker of frailty. Several studies have reported that preoperativesarcopenia predicted risks in long-term results.We evaluate the impact of sarcopenia for outcomes in off-pump coronary bypass (OPCAB).METHODS: We retrospectively reviewed 733 patients who underwentelective OPCAB in our institution from September 2008 to July 2018. Patients without preoperative computed tomography (CT) of the abdomen were excluded. Finally, 511 patients were included. Sarcopenia was assessed by the psoas muscle area index (PMI, cm2/m2)[defined as the psoas muscle area at the L3 level (cm2) / body surface area (m2)]. The cut-off value for sarcopenia was 7.9 cm2/m2in male and 4.4 cm2/m2in female patients. These patients were classified into the sarcopenia (Group S, n = 66) and non-sarcopenia group (Group N, n = 445). RESULTS: Preoperative characteristics in these two groups (group S vs N) were the age (71.7±7.5 vs.68.5±10.3 years P = 0.036), BSA was (1.63±0.38 vs. 1.64±0.1m2 P=0.21)and PMI was(5.4±1.1 vs. 9.2±2.3m2 P<0.001). Operation time was (261.7±57.1 vs 241.9±55.5 min P=0.96), the average number of anastomosis (3.3±0.9 vs 3.2±1.0P = 0.4), Postoperative hospital stay was longer in group S than group N(15.3±14.3 v.s. 12.7±5.9 day P=0.034). One patient (0.2%) in group N were died within 30days. In the Kaplan-Meier survival analysis demonstrated that, 92.6% vs 96.3%in 1 year, 85.8% vs 90.4%in 3 years, 72.0% vs 84.2%in 5 years (P = 0.36). MACCE (cardiac death, acute myocardium infarction, stroke, revascularization, readmission due to heart failure)was 94.2% vs.94.9%in 1 year, 88.6% vs.87.2%in 3 years, 77.3% vs.81.7%in 5 years (P = 0.98).CONCLUSION: Preoperative sarcopenia does not impact on long term outcomes after OPCAB.
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