Low Muscle Mass as a Prognostic Factor for Early Postoperative Outcomes in Pediatric Patients Undergoing the Fontan Operation: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants and Measurements
2.2. Clinical Variables and Postoperative Outcomes
2.3. Skeletal Muscle Mass Measurement Using Chest CT and the Definition of Low Muscle Mass
2.4. Statistical Analysis
3. Results
3.1. Study Population
3.2. Low Muscle Mass Assessment
3.3. Correlation Between Low Muscle Mass and Early Postoperative Complications
3.4. Association between Low Muscle Mass and Poor Postoperative Outcomes
4. Discussion
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Total (n = 74) | Low Muscle Mass (n = 31) | High Muscle Mass (n = 43) | |
---|---|---|---|
Demographic Variables | |||
Age, year | 2.9 (2.8–3.3) | 3.0 (2.8–3.0) | 3.0 (2.7–3.5) |
Sex, male | 38 (51) | 16 (52) | 22 (51) |
Weight, kg | 14.0 (13.0–15.6) | 13.9 (12.8–14.8) | 14.2 (13.1–16.2) |
Height, cm | 93.3 (91.3–96.1) | 93.3 (91.7–94.8) | 93.4 (91.2–96.9) |
Body surface area, m2 | 0.60 (0.58–0.64) | 0.60 (0.58–0.65) | 0.60 (0.57–0.68) |
Birth weight, kg | 3.17 (2.80–3.46) | 3.10 (2.73–3.37) | 3.19 (2.84–3.49) |
Premature birth | 11 (15) | 4 (13) | 7 (16) |
Computed Tomography Measurements | |||
PMI, cm2/m2 | 13.1 (9.8–15.9) | 9.5 (9.0–10.8) | 15.8 (13.1–17.2) * |
ESMI, cm2/m2 | 8.6 (6.5–10.5) | 6.3 (5.6–7.0) | 10.4 (8.9–11.7) * |
TSMI, cm2/m2 | 21.7 (16.9–26.4) | 16.5(14.7–17.8) | 24.9 (22.2–28.8) * |
Intraoperative Variables | |||
Anesthesia duration, min | 391 ± 112 | 410 ± 149 | 379 ± 77 |
Surgical duration, min | 331 ± 107 | 348 ± 140 | 318 ± 75 |
CPB duration, min | 110 ± 78 | 128 ± 117 | 99 ± 34 |
VISmax1 | 5.0 (5.0–9.4) | 7.0 (5.0–10.0) | 5.0 (5.0–8.0) * |
Postoperative Variables | |||
VISmax2 | 10.0 (5.5–12.5) | 10.0 (7.0–17.5) | 8.0 (5.0–10.0) |
Duration of MV, h | 20 (13–43) | 22 (16–53) | 17 (13–33) |
ICU stay, days | 3 (2–7) | 4 (2–9) | 3 (2–4) * |
Hospital stay, days | 24 (12–30) | 15 (12–45) | 15 (12–20) |
Major postoperative complications | 21 (28) | 15 (48) | 6 (14) * |
Univariate | Multivariable | |||
---|---|---|---|---|
OR (95% CI) | P | OR (95% CI) | P | |
Major Postoperative Complications | ||||
Age, year | 0.70 (0.40–1.21) | 0.202 | ||
Sex, male | 0.62 (0.20–2.00) | 0.428 | ||
Body weight, kg | 1.24 (0.97–1.60) | 0.087 | ||
Premature birth | 1.93 (0.35–10.6) | 0.447 | ||
CPB duration, min | 1.00 (0.99–1.01) | 0.432 | ||
TSMI, cm2/m2 | 0.89 (0.81–0.99) | 0.031 | 0.90 (0.82–0.99) | 0.039 |
Duration of ICU Stay > 5 Days | ||||
Age, year | 1.17 (0.66–2.06) | 0.585 | ||
Sex, male | 1.56 (0.47–5.13) | 0.156 | ||
Body weight, kg | 0.88 (0.69–1.12) | 0.306 | ||
Premature birth | 4.97 (0.52–47.1) | 0.162 | ||
CPB duration, min | 1.00 (1.00–1.01) | 0.318 | ||
TSMI, cm2/m2 | 0.87 (0.78–0.97) | 0.014 | 0.86 (0.77–0.96) | 0.006 |
Duration of Hospital Stay > 14 days | ||||
Age, year | 1.35 (0.88–2.08) | 0.175 | ||
Sex, male | 0.90 (0.31–2.61) | 0.841 | ||
Body weight, kg | 0.88 (0.73–1.05) | 0.882 | ||
Premature birth | 2.13 (0.52–8.75) | 0.292 | ||
CPB duration, min | 1.00 (1.00–1.01) | 0.444 | ||
TSMI, cm2/m2 | 0.92 (0.85–0.99) | 0.039 | 0.92 (0.85–0.99) | 0.035 |
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Oh, J.; Shin, W.-J.; Jeong, D.; Yun, T.-J.; Park, C.S.; Choi, E.S.; Choi, J.M.; Gwak, M.; Song, I.-K. Low Muscle Mass as a Prognostic Factor for Early Postoperative Outcomes in Pediatric Patients Undergoing the Fontan Operation: A Retrospective Cohort Study. J. Clin. Med. 2019, 8, 1257. https://doi.org/10.3390/jcm8081257
Oh J, Shin W-J, Jeong D, Yun T-J, Park CS, Choi ES, Choi JM, Gwak M, Song I-K. Low Muscle Mass as a Prognostic Factor for Early Postoperative Outcomes in Pediatric Patients Undergoing the Fontan Operation: A Retrospective Cohort Study. Journal of Clinical Medicine. 2019; 8(8):1257. https://doi.org/10.3390/jcm8081257
Chicago/Turabian StyleOh, Jimi, Won-Jung Shin, DaUn Jeong, Tae-Jin Yun, Chun Soo Park, Eun Seok Choi, Jae Moon Choi, Mijeung Gwak, and In-Kyung Song. 2019. "Low Muscle Mass as a Prognostic Factor for Early Postoperative Outcomes in Pediatric Patients Undergoing the Fontan Operation: A Retrospective Cohort Study" Journal of Clinical Medicine 8, no. 8: 1257. https://doi.org/10.3390/jcm8081257