Perioperative changes in radiographic density in erector spinae muscle and mortality after lung transplantation

Yohei Oshima; Susumu Sato; Toyofumi F Chen-Yoshikawa; Daisuke Nakajima; Yuji Yoshioka; Ryota Hamada; Taishi Kajimoto; Ayumi Otagaki; Manabu Nankaku; Naoya Tanabe; Ryosuke Ikeguchi; Hiroshi Date; Shuichi Matsuda

doi:10.1016/j.rmed.2023.107482

Perioperative changes in radiographic density in erector spinae muscle and mortality after lung transplantation

Respir Med. 2024 Jan:221:107482. doi: 10.1016/j.rmed.2023.107482. Epub 2023 Dec 4.

Affiliations

¹ Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.
² Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan; Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Japan. Electronic address: ssato@kuhp.kyoto-u.ac.jp.
³ Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, Aichi, Japan; Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁴ Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

PMID: 38056531
DOI: 10.1016/j.rmed.2023.107482

Abstract

Rationale: The radiographic density of the erector spinae muscle (ESM) is often decreased early after lung transplantation (LTx). The prognostic impact of this change has not been elucidated.

Objective: To investigate whether the decrease in the radiographic density of ESMs early after LTx is associated with a poor prognosis.

Methods: This study is a single center retrospective cohort study. Routine follow-up chest computed tomography scan data just before and 12 weeks after LTx were retrospectively retrieved for adult patients who underwent primary LTx at Kyoto University Hospital. The radiographic density of ESM was quantitatively evaluated as the mean attenuation of the ESM (ESMct), and the impact of the decreased ESMct during the 12 weeks after LTx on overall survival (OS) was examined by Cox proportional hazard regression.

Results: A total of 151 recipients (94 cadaveric LTx, 57 living-donor lobar LTx) were included in this study. The median duration of postoperative observation was 4.4 years, during which time 39 recipients (26%) died. Decreased postoperative ESMct was significantly associated with poor OS (HR, 1.64; 95% CI, 1.14-2.35, P = 0.008 per 1 Z score decrease) in the multivariate model adjusted for age, sex, episodes of acute rejection, and preoperative ESMct. Similar results were obtained when the subjects were limited to those with cadaveric LTx.

Conclusion: A decreased perioperative ESMct was strongly associated with a poor prognosis after LTx in addition to low preoperative ESMct. Maintaining postoperative muscle radiographic density, which reflects muscle quality, may be important for a better prognosis after LTx.

Keywords: Computed tomography; Lung transplantation; Mortality; Muscle radiographic density; Skeletal muscle.

MeSH terms

Adult
Cadaver
Humans
Lung Transplantation*
Muscles
Prognosis
Retrospective Studies