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Effect of preoperative erector spinae muscles mass on postoperative outcomes in patients with left ventricular assist devices
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  • Yukiharu Sugimura,
  • Nihat Sipahi,
  • Moritz Immohr,
  • Esma Yilmaz,
  • Joel Aissa,
  • Udo Boeken,
  • Hug Aubin,
  • Artur Lichtenberg,
  • Payam Akhyari,
  • Hannan Dalyanoglu
Yukiharu Sugimura
Heinrich-Heine-Universitat Dusseldorf
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Nihat Sipahi
Universitatsklinikum Dusseldorf
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Moritz Immohr
Heinrich Heine University Düsseldorf
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Esma Yilmaz
Dep. of Cardiovascular Surgery
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Joel Aissa
University Hospital Dusseldorf
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Udo Boeken
Dep. of Cardiovascular Surgery
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Hug Aubin
Heinrich-Heine-University Düsseldorf
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Artur Lichtenberg
University Hospital Dusseldorf
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Payam Akhyari
Medical Faculty, Heinrich-Heine University
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Hannan Dalyanoglu
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Abstract

Background: Frailty influences the postoperative outcomes in patients undergoing left ventricular assist device (LVAD) implantation; however, a quantitative evaluation method has not been established. The purpose of the present study was to evaluate whether preoperative ESM mass is associated with short- and long-term clinical outcomes in patients with LVAD. Methods: A total of 119 consecutive patients with LVAD were enrolled between January 2010 and October 2017 at a single heart center. The ESM index and Hounsfield units (HU) of the ESM were calculated by computed tomography for preoperative ESM mass evaluation. We then statistically evaluated the in-hospital mortality, major adverse cardiovascular events (MACE), duration of hospital stay, and long-term survival. Results: In a multivariate Cox regression analysis, ESM index and HU of the ESM indicated no effect on the in-hospital mortality, MACE, and long-term survival. In addition, the ESM index presented a weak but significant negative linear correlation only with the duration of hospital stay (r = -0.21, p < 0.05). In contrast, the model for end-stage liver disease (MELD) score and preoperative venous-arterial extracorporeal membrane oxygenation (va-ECMO) were significant predictive factors for in-hospital mortality (MELD score: p < 0.001, hazard ratio [HR] 1.1; preoperative va-ECMO: p < 0.01, HR 2.72) and MACE (MELD score: p < 0.001, HR 1.07; preoperative va-ECMO: p < 0.005, HR 2.62). Conclusion: Preoperative ESM mass might predict the length of hospital stay in patients undergoing LVAD implantation. In contrast, it had no effect on MACE, in-hospital mortality, or long-term survival in this study.

Peer review status:UNDER REVIEW

22 May 2021Submitted to Journal of Cardiac Surgery
22 May 2021Assigned to Editor
22 May 2021Submission Checks Completed
24 May 2021Reviewer(s) Assigned
12 Jun 2021Review(s) Completed, Editorial Evaluation Pending