Association of temporalis muscle thickness with functional outcomes in patients undergoing endovascular thrombectomy

Yen-Heng Lin; Chi-Ting Chung; Chih-Hao Chen; Chang-Jie Cheng; Hai-Jui Chu; Kuo-Wei Chen; Shin-Joe Yeh; Li-Kai Tsai; Chung-Wei Lee; Sung-Chun Tang; Jiann-Shing Jeng

doi:10.1016/j.ejrad.2023.110808

Association of temporalis muscle thickness with functional outcomes in patients undergoing endovascular thrombectomy

Eur J Radiol. 2023 Jun:163:110808. doi: 10.1016/j.ejrad.2023.110808. Epub 2023 Apr 7.

Authors

Affiliations

¹ Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
² Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
³ Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan.
⁴ Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan.
⁵ Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
⁶ Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: rad.chungweilee@gmail.com.

PMID: 37080063
DOI: 10.1016/j.ejrad.2023.110808

Abstract

Introduction: Temporalis muscle thickness (TMT) is a surrogate marker for sarcopenia. This study investigated the association of TMT with clinical outcomes in patients receiving endovascular thrombectomy (EVT) for stroke involving acute large vessel occlusion (LVO).

Material and methods: We enrolled consecutive patients who had undergone EVT between September 2014 and December 2021 at three thrombectomy-capable institutes. TMT was measured through preprocedural computerized tomography angiography. The clinical variables affecting TMT were investigated. The associations between TMT and clinical functional outcomes, defined using the modified Rankin scale, were also studied.

Results: A total of 657 patients were included (mean age: 72.0 ± 12.7 years; male: 52.1%). The mean TMT was 6.35 ± 1.84 mm. Younger age, male sex, higher body mass index, and premorbid functional independence were associated with larger TMT in both univariate and multivariate linear regression (P <.05). Ordinal logistic regression revealed that TMT was associated with better clinical outcomes at 90 days (P_trend = 0.047); multivariate logistic regression indicated that larger TMT was an independent predictor (adjusted odds ratio: 1.14, 95% confidence interval: 1.03-1.27, P = 0.02) of favorable functional independence (modified Rankin scale score: 0-2). The effect was stronger in older patients (≥80 years) than younger patients, as revealed by interaction modeling analysis (P_interaction = 0.06).

Conclusion: TMT is associated with age, sex, body mass index, and premorbid functional status. Larger TMT is associated with better outcomes after EVT. The effects of TMT are more pronounced in older adults, indicating that sarcopenia may have influence on stroke outcomes.

Keywords: Prognosis; Sarcopenia; Stroke; Thromectomy.

MeSH terms

Aged
Aged, 80 and over
Brain Ischemia*
Endovascular Procedures* / methods
Humans
Male
Middle Aged
Muscles
Sarcopenia*
Stroke* / diagnostic imaging
Stroke* / etiology
Stroke* / surgery
Thrombectomy / methods
Treatment Outcome