Sarcopenia is a prognostic factor for overall survival in patients with critical limb ischemia

Yutaka Matsubara, Takuya Matsumoto, Yukihiko Aoyagi, Shinichi Tanaka, Jun Okadome, Koichi Morisaki, Ken Shirabe, Yoshihiko Maehara

Research output: Contribution to journalArticle

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Abstract

Background Sarcopenia has been proposed as a prognostic factor for various diseases. Patients with critical limb ischemia (CLI) have a very poor prognosis, but sarcopenia has not been reported as a prognostic factor for CLI patients. If sarcopenia is associated with the prognosis of CLI patients, it could help select the treatment plan. Therefore, we examined whether sarcopenia is a prognostic factor for CLI patients. Methods We performed a retrospective study of CLI patients diagnosed with Fontaine III or IV peripheral artery disease who underwent preoperative computed tomography imaging and revascularization between January 2002 and December 2009. The presence of sarcopenia was defined as skeletal muscle area of <114.0 cm2 for men or <89.8 cm2 for women using transverse computed tomography scans at the third lumbar vertebra. We compared the 5-year survival rate and clinical characteristics between patients with or without sarcopenia. We also screened possible prognostic factors for overall survival using hazard ratios (HRs) with 95% confidence intervals (CIs). Results Of 64 eligible patients, 28 patients had sarcopenia and 36 did not. There were significant differences in age, skeletal muscle area, body mass index, and the presence of smoking, cerebrovascular disease, and hemodialysis between patients with and without sarcopenia (all P <.05). The 5-year survival rate was significantly lower in patients with sarcopenia (23.5% vs 77.5%, P =.001). Prognostic factors for overall survival were the presence of sarcopenia (HR, 3.22; 95% CI, 1.24-9.11; P =.02), requirement for hemodialysis (HR, 4.30; 95% CI, 1.60-12.2; P =.004), and postoperative complications (HR, 5.02; 95% CI, 1.90-13.7; P =.001). Conclusions Our results suggest that sarcopenia is a prognostic factor for CLI patients. Exercise and nutritional interventions focusing on improving sarcopenia might be useful treatment options for CLI patients.

Original languageEnglish
Pages (from-to)945-950
Number of pages6
JournalJournal of Vascular Surgery
Volume61
Issue number4
DOIs
Publication statusPublished - Apr 1 2015

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Sarcopenia
Ischemia
Extremities
Survival
Confidence Intervals
Renal Dialysis
Skeletal Muscle
Survival Rate
Tomography
Cerebrovascular Disorders
Lumbar Vertebrae
Peripheral Arterial Disease

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Sarcopenia is a prognostic factor for overall survival in patients with critical limb ischemia. / Matsubara, Yutaka; Matsumoto, Takuya; Aoyagi, Yukihiko; Tanaka, Shinichi; Okadome, Jun; Morisaki, Koichi; Shirabe, Ken; Maehara, Yoshihiko.

In: Journal of Vascular Surgery, Vol. 61, No. 4, 01.04.2015, p. 945-950.

Research output: Contribution to journalArticle

Matsubara, Y, Matsumoto, T, Aoyagi, Y, Tanaka, S, Okadome, J, Morisaki, K, Shirabe, K & Maehara, Y 2015, 'Sarcopenia is a prognostic factor for overall survival in patients with critical limb ischemia', Journal of Vascular Surgery, vol. 61, no. 4, pp. 945-950. https://doi.org/10.1016/j.jvs.2014.10.094
Matsubara, Yutaka ; Matsumoto, Takuya ; Aoyagi, Yukihiko ; Tanaka, Shinichi ; Okadome, Jun ; Morisaki, Koichi ; Shirabe, Ken ; Maehara, Yoshihiko. / Sarcopenia is a prognostic factor for overall survival in patients with critical limb ischemia. In: Journal of Vascular Surgery. 2015 ; Vol. 61, No. 4. pp. 945-950.
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T1 - Sarcopenia is a prognostic factor for overall survival in patients with critical limb ischemia

AU - Matsubara, Yutaka

AU - Matsumoto, Takuya

AU - Aoyagi, Yukihiko

AU - Tanaka, Shinichi

AU - Okadome, Jun

AU - Morisaki, Koichi

AU - Shirabe, Ken

AU - Maehara, Yoshihiko

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N2 - Background Sarcopenia has been proposed as a prognostic factor for various diseases. Patients with critical limb ischemia (CLI) have a very poor prognosis, but sarcopenia has not been reported as a prognostic factor for CLI patients. If sarcopenia is associated with the prognosis of CLI patients, it could help select the treatment plan. Therefore, we examined whether sarcopenia is a prognostic factor for CLI patients. Methods We performed a retrospective study of CLI patients diagnosed with Fontaine III or IV peripheral artery disease who underwent preoperative computed tomography imaging and revascularization between January 2002 and December 2009. The presence of sarcopenia was defined as skeletal muscle area of <114.0 cm2 for men or <89.8 cm2 for women using transverse computed tomography scans at the third lumbar vertebra. We compared the 5-year survival rate and clinical characteristics between patients with or without sarcopenia. We also screened possible prognostic factors for overall survival using hazard ratios (HRs) with 95% confidence intervals (CIs). Results Of 64 eligible patients, 28 patients had sarcopenia and 36 did not. There were significant differences in age, skeletal muscle area, body mass index, and the presence of smoking, cerebrovascular disease, and hemodialysis between patients with and without sarcopenia (all P <.05). The 5-year survival rate was significantly lower in patients with sarcopenia (23.5% vs 77.5%, P =.001). Prognostic factors for overall survival were the presence of sarcopenia (HR, 3.22; 95% CI, 1.24-9.11; P =.02), requirement for hemodialysis (HR, 4.30; 95% CI, 1.60-12.2; P =.004), and postoperative complications (HR, 5.02; 95% CI, 1.90-13.7; P =.001). Conclusions Our results suggest that sarcopenia is a prognostic factor for CLI patients. Exercise and nutritional interventions focusing on improving sarcopenia might be useful treatment options for CLI patients.

AB - Background Sarcopenia has been proposed as a prognostic factor for various diseases. Patients with critical limb ischemia (CLI) have a very poor prognosis, but sarcopenia has not been reported as a prognostic factor for CLI patients. If sarcopenia is associated with the prognosis of CLI patients, it could help select the treatment plan. Therefore, we examined whether sarcopenia is a prognostic factor for CLI patients. Methods We performed a retrospective study of CLI patients diagnosed with Fontaine III or IV peripheral artery disease who underwent preoperative computed tomography imaging and revascularization between January 2002 and December 2009. The presence of sarcopenia was defined as skeletal muscle area of <114.0 cm2 for men or <89.8 cm2 for women using transverse computed tomography scans at the third lumbar vertebra. We compared the 5-year survival rate and clinical characteristics between patients with or without sarcopenia. We also screened possible prognostic factors for overall survival using hazard ratios (HRs) with 95% confidence intervals (CIs). Results Of 64 eligible patients, 28 patients had sarcopenia and 36 did not. There were significant differences in age, skeletal muscle area, body mass index, and the presence of smoking, cerebrovascular disease, and hemodialysis between patients with and without sarcopenia (all P <.05). The 5-year survival rate was significantly lower in patients with sarcopenia (23.5% vs 77.5%, P =.001). Prognostic factors for overall survival were the presence of sarcopenia (HR, 3.22; 95% CI, 1.24-9.11; P =.02), requirement for hemodialysis (HR, 4.30; 95% CI, 1.60-12.2; P =.004), and postoperative complications (HR, 5.02; 95% CI, 1.90-13.7; P =.001). Conclusions Our results suggest that sarcopenia is a prognostic factor for CLI patients. Exercise and nutritional interventions focusing on improving sarcopenia might be useful treatment options for CLI patients.

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