Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis
Abstract Background Low muscle mass is common in patients approaching lung transplantation and may be linked to worse post-transplant outcomes. Existing studies assessing muscle mass and post-transplant outcomes include few patients with cystic fibrosis (CF). Methods Between May 1993 and December 20...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-023-02398-4 |
| _version_ | 1797854085803671552 |
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| author | Ann L Jennerich Lois Downey Christopher H Goss Siddhartha G Kapnadak Joseph B Pryor Kathleen J Ramos |
| author_facet | Ann L Jennerich Lois Downey Christopher H Goss Siddhartha G Kapnadak Joseph B Pryor Kathleen J Ramos |
| author_sort | Ann L Jennerich |
| collection | DOAJ |
| description | Abstract Background Low muscle mass is common in patients approaching lung transplantation and may be linked to worse post-transplant outcomes. Existing studies assessing muscle mass and post-transplant outcomes include few patients with cystic fibrosis (CF). Methods Between May 1993 and December 2018, 152 adults with CF received lung transplants at our institution. Of these, 83 met inclusion criteria and had usable computed tomography (CT) scans. Using Cox proportional hazards regression, we evaluated the association between pre-transplant thoracic skeletal muscle index (SMI) and our primary outcome of death after lung transplantation. Secondary outcomes, including days to post-transplant extubation and post-transplant hospital and intensive care unit (ICU) length of stay, were assessed using linear regression. We also examined associations between thoracic SMI and pre-transplant pulmonary function and 6-min walk distance. Results Median thoracic SMI was 26.95 cm2/m2 (IQR 23.97, 31.32) for men and 22.83 cm2/m2 (IQR 21.27, 26.92) for women. There was no association between pre-transplant thoracic SMI and death after transplant (HR 1.03; 95% CI 0.95, 1.11), days to post-transplant extubation, or post-transplant hospital or ICU length of stay. There was an association between pre-transplant thoracic SMI and pre-transplant FEV1% predicted (b = 0.39; 95% CI 0.14, 0.63), with higher SMI associated with higher FEV1% predicted. Conclusions Skeletal muscle index was low for men and women. We did not identify a significant relationship between pre-transplant thoracic SMI and post-transplant outcomes. There was an association between thoracic SMI and pre-transplant pulmonary function, confirming the potential value of sarcopenia as a marker of disease severity. |
| first_indexed | 2024-04-09T20:01:20Z |
| format | Article |
| id | doaj.art-dbf0fba2d19c448f8c8c80562c79d986 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-09T20:01:20Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-dbf0fba2d19c448f8c8c80562c79d9862023-04-03T05:15:09ZengBMCBMC Pulmonary Medicine1471-24662023-03-012311910.1186/s12890-023-02398-4Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosisAnn L Jennerich0Lois Downey1Christopher H Goss2Siddhartha G Kapnadak3Joseph B Pryor4Kathleen J Ramos5Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of WashingtonDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of WashingtonDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of WashingtonDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of WashingtonDepartment of General Internal Medicine, University of WashingtonDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of WashingtonAbstract Background Low muscle mass is common in patients approaching lung transplantation and may be linked to worse post-transplant outcomes. Existing studies assessing muscle mass and post-transplant outcomes include few patients with cystic fibrosis (CF). Methods Between May 1993 and December 2018, 152 adults with CF received lung transplants at our institution. Of these, 83 met inclusion criteria and had usable computed tomography (CT) scans. Using Cox proportional hazards regression, we evaluated the association between pre-transplant thoracic skeletal muscle index (SMI) and our primary outcome of death after lung transplantation. Secondary outcomes, including days to post-transplant extubation and post-transplant hospital and intensive care unit (ICU) length of stay, were assessed using linear regression. We also examined associations between thoracic SMI and pre-transplant pulmonary function and 6-min walk distance. Results Median thoracic SMI was 26.95 cm2/m2 (IQR 23.97, 31.32) for men and 22.83 cm2/m2 (IQR 21.27, 26.92) for women. There was no association between pre-transplant thoracic SMI and death after transplant (HR 1.03; 95% CI 0.95, 1.11), days to post-transplant extubation, or post-transplant hospital or ICU length of stay. There was an association between pre-transplant thoracic SMI and pre-transplant FEV1% predicted (b = 0.39; 95% CI 0.14, 0.63), with higher SMI associated with higher FEV1% predicted. Conclusions Skeletal muscle index was low for men and women. We did not identify a significant relationship between pre-transplant thoracic SMI and post-transplant outcomes. There was an association between thoracic SMI and pre-transplant pulmonary function, confirming the potential value of sarcopenia as a marker of disease severity.https://doi.org/10.1186/s12890-023-02398-4Lung diseasesLung transplantationNutritional statusSurvival analysis |
| spellingShingle | Ann L Jennerich Lois Downey Christopher H Goss Siddhartha G Kapnadak Joseph B Pryor Kathleen J Ramos Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis BMC Pulmonary Medicine Lung diseases Lung transplantation Nutritional status Survival analysis |
| title | Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis |
| title_full | Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis |
| title_fullStr | Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis |
| title_full_unstemmed | Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis |
| title_short | Computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis |
| title_sort | computed tomography body composition and clinical outcomes following lung transplantation in cystic fibrosis |
| topic | Lung diseases Lung transplantation Nutritional status Survival analysis |
| url | https://doi.org/10.1186/s12890-023-02398-4 |
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