瘦腰肌面积与CLTI下肢血管重建术后的住院时间有关
Lean Psoas Muscle Area Is Associated with Length of Stay After Lower Limb Revascularization for CLTI.
摘要(中文译文)
背景：慢性肢体威胁性缺血（CLTI）与高发病率和大量医疗利用有关。下肢血运重建术后的住院时间（LOS）受到手术复杂性的影响，但患者的生理储备也可能发挥作用。我们评估了CT衍生的瘦腰肌面积（LPMA）是否与接受CLTI血运重建的患者的LOS独立相关。方法：我们回顾性分析了2018年至2021年间接受CLTI（卢瑟福4-5）血管内、混合或开放式血运重建的234名连续患者。肌减少标志物来源于L3水平的术前CT，包括腰肌面积（PMA）、肌肉密度（PMD）和LPMA。使用具有对数变换LOS的多变量线性回归模型来估计对住院时间的相对影响。结果：中位年龄为68岁，男性占65.4%；76.5%的入院情况紧急。中位服务水平为6天（IQR 4-9）。手术类型是LOS的最强决定因素：与血管内治疗相比，混合手术（β=0.69，p<0.001）和开放手术（β=0.73，p<0.001）的LOS分别延长了约99%和108%。较高的LPMA与较短的LOS独立相关（β=-0.00049，p=0.004）。吸烟（β=-0.21，p=0.003）和心肌梗死史（β=-019，p=0.030）与较短的LOS相关，而透析显示出住院时间较长的非显著趋势（β=0.36，p=0.056）。结论：在接受CLTI下肢血运重建的患者中，经手术和临床因素调整后，CT衍生的LPMA与住院时间呈适度但独立的相关性。鉴于这项研究的探索性，这些产生假设的发现支持进一步评估基于成像的肌肉评估作为这一高危人群生理储备的辅助标志。
Abstract
: Chronic limb-threatening ischemia (CLTI) is associated with high morbidity and substantial healthcare utilization. Length of hospital stay (LOS) after lower limb revascularization is influenced by procedural complexity, but patient physiological reserve may also play a role. We evaluated whether CT-derived lean psoas muscle area (LPMA) is independently associated with LOS in patients undergoing revascularization for CLTI. : We retrospectively analyzed 234 consecutive patients treated with endovascular, hybrid, or open revascularization for CLTI (Rutherford 4-5) between 2018 and 2021. Sarcopenia markers were derived from preoperative CT at the L3 level, including psoas muscle area (PMA), muscle density (PMD), and LPMA. Multivariable linear regression models with log-transformed LOS were used to estimate relative effects on hospitalization duration. : Median age was 68 years and 65.4% were male; 76.5% of admissions were urgent. Median LOS was 6 days (IQR 4-9). Procedure type was the strongest determinant of LOS: hybrid (β = 0.69, < 0.001) and open surgery (β = 0.73, < 0.001) were associated with approximately 99% and 108% longer LOS compared with endovascular treatment. Higher LPMA was independently associated with shorter LOS (β = -0.00049, = 0.004). Smoking (β = -0.21, = 0.003) and history of myocardial infarction (β = -0.19, = 0.030) were associated with shorter LOS, whereas dialysis showed a non-significant trend toward longer hospitalization (β = 0.36, = 0.056). : In patients undergoing lower limb revascularization for CLTI, CT-derived LPMA demonstrated a modest but independent association with hospital stay duration after adjustment for procedural and clinical factors. Given the exploratory nature of this study, these hypothesis-generating findings support further evaluation of imaging-based muscle assessment as an adjunct marker of physiological reserve in this high-risk population.
如何引用
AMA
Jagoda Bobula, Joanna Halman, Kamil Myszczyński, Jakub Dybcio, Nina Kimilu, Agnieszka Blacha, et al. Lean Psoas Muscle Area Is Associated with Length of Stay After Lower Limb Revascularization for CLTI.. Diagnostics (Basel, Switzerland). 2026; doi:10.3390/diagnostics16111621.
APA
Jagoda Bobula, Joanna Halman, Kamil Myszczyński, Jakub Dybcio, Nina Kimilu, Agnieszka Blacha, et al (2026). Lean Psoas Muscle Area Is Associated with Length of Stay After Lower Limb Revascularization for CLTI.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics16111621
GB/T 7714
Jagoda Bobula, Joanna Halman, Kamil Myszczyński, Jakub Dybcio, Nina Kimilu, Agnieszka Blacha, et al. Lean Psoas Muscle Area Is Associated with Length of Stay After Lower Limb Revascularization for CLTI.[J]. Diagnostics (Basel, Switzerland), 2026 doi:10.3390/diagnostics16111621.
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