Osteosarcopenia-Aneurysm Score Predicts Long-Term Survival Following Endovascular Repair for Abdominal Aortic Aneurysm.

BACKGROUND

Estimated prognosis plays an important role in the operative decision-making process in the management of abdominal aortic aneurysms (AAAs). We aimed to develop a composite score to predict overall survival following endovascular aneurysm repair (EVAR) for AAAs based on bone mineral density (BMD) and psoas muscle index.

METHODS

This was a single-center, retrospective cohort study of 237 patients undergoing primary EVAR for AAA between 2016 and 2019. BMD was assessed by measuring the Hounsfield units of the 11th thoracic vertebra on preoperative computed tomography; a BMD value of <110 Hounsfield units was considered osteoporosis. The psoas muscle index was used in the diagnosis of sarcopenia.

RESULTS

A multivariable analysis showed that age (hazard ratio [HR], 1.07, 95% confidence interval [CI], 1.04-1.11; P < 0.001), aneurysm diameter (HR, 1.05, 95% CI, 1.02-1.08; P = 0.001), osteoporosis (HR, 1.69, 95% CI, 1.12-2.55; P = 0.013), and sarcopenia (HR, 2.20, 95% CI, 1.34-3.60; P = 0.002) were found to be independent risk factors for all-cause mortality. Osteosarcopenia-aneurysm score (OSAS) was defined as the sum of the following factors: elderly (≥80 years), large aneurysm (≥55 mm), osteoporosis, and sarcopenia. In a receiver-operating characteristic analysis in predicting of 5-year mortality, the area under the curve (AUC) for the OSAS was comparable to that for the Glasgow Aneurysm Score (AUC for OSAS: 0.75, 95% CI, 0.69-0.82 vs. AUC for Glasgow Aneurysm Score: 0.74, 95% CI, 0.67-0.81; P = 0.69).

CONCLUSION

We believe that the OSAS is applicable to predict long-term survival following EVAR.