Predictability of Radiologically Measured Psoas Muscle Area for Intraoperative Hypotension in Older Adult Patients Undergoing Femur Fracture Surgery.
Youn Young LeeJae Hee WooIn-Young YoonHyun Jung LeeSang-Mee AhnJi Seon ChaeYoun Jin KimPublished in: Journal of clinical medicine (2023)
This retrospective study aimed to determine the predictive value of radiologically measured psoas muscle area (PMA) for intraoperative hypotension (IOH) using receiver operating characteristic (ROC) curves in older adult patients with hip fractures. The cross-sectional axial area of the psoas muscle was measured by CT at the level of the 4th lumbar vertebrae and normalized by body surface area (BSA). The modified frailty index (mFI) was used to assess frailty. IOH was defined as an absolute threshold of mean arterial blood pressure (MAP) < 65 mmHg or a relative decrease in MAP > 30% from baseline MAP. Among the 403 patients, 286 (71.7%) had developed IOH. PMA normalized by BSA in male patients was 6.90 ± 0.73 in the no-IOH group and 4.95 ± 1.20 in the IOH group ( p < 0.001). PMA normalized by BSA in female patients was 5.18 ± 0.81 in the no-IOH group and 3.78 ± 0.75 in the IOH group ( p < 0.001). The ROC curves showed that the area under the curve for PMA normalized by BSA and modified frailty index (mFI) were 0.94 for male patients, 0.91 for female patients, and 0.81 for mFI ( p < 0.001). In multivariate logistic regression, low PMA normalized by BSA, high baseline systolic blood pressure, and old age were significant independent predictors of IOH (adjusted odds ratio: 3.86, 1.03, and 1.06, respectively). PMA measured by computed tomography showed an excellent predictive value for IOH. Low PMA was associated with developing IOH in older adult patients with hip fractures.
Keyphrases
- end stage renal disease
- blood pressure
- computed tomography
- chronic kidney disease
- ejection fraction
- patients undergoing
- newly diagnosed
- peritoneal dialysis
- prognostic factors
- heart failure
- cross sectional
- minimally invasive
- skeletal muscle
- metabolic syndrome
- left ventricular
- coronary artery disease
- magnetic resonance
- young adults
- insulin resistance
- community dwelling
- body composition
- childhood cancer
- data analysis