The following is a summary of “Perioperative changes in radiographic density in erector spinae muscle and mortality after lung transplantation,” published in the January 2024 issue of Pulmonology by Oshima, et al.
Following lung transplantation (LTx), the radiographic density of the erector spinae muscle (ESM) often decreases. However, the significance of this change in terms of prognosis remains unclear. For a study, researchers sought to investigate whether the reduction in radiographic density of ESM early after LTx is correlated with a poorer prognosis.
The retrospective cohort study was conducted at a single center. Data from routine follow-up chest computed tomography scans obtained just before and 12 weeks after LTx were retrospectively collected for adult patients who underwent primary LTx at Kyoto University Hospital. The radiographic density of ESM was quantitatively assessed as the mean attenuation of the ESM (ESMct). The impact of decreased ESMct during the 12 weeks after LTx on overall survival (OS) was examined using Cox proportional hazard regression analysis.
A total of 151 recipients (94 cadaveric LTx, 57 living-donor lobar LTx) were included in the study. The median postoperative observation period was 4.4 years, during which 39 recipients (26%) died. Decreased postoperative ESMct was significantly associated with poorer 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 analysis was limited to subjects who underwent cadaveric LTx.
A reduction in perioperative ESMct was strongly linked to a poorer prognosis following LTx, in addition to low preoperative ESMct. Maintaining postoperative muscle radiographic density, indicative of muscle quality, may play a crucial role in improving prognosis after LTx.
Reference: resmedjournal.com/article/S0954-6111(23)00370-0/fulltext