Despite the National Emphysema Treatment Trial’s selection criteria, lung volume reduction surgery still has a high morbidity rate. Researchers investigated the relationship between analytic morphomics on chest computed tomography scans and outcomes following lung volume reduction surgery. Analytic morphomics measured dorsal muscle group area, subcutaneous and visceral fat area, and bone mineral density in 85 lung volume reduction surgery patients from 1998 to 2013. Researchers separated the density of the lungs into five stages, each of which increased in density (Lung density 1, emphysema; 2, normal lung; 4-5, scarring). Univariate and multivariate approaches were used to examine outcomes such as survival, hospital length of stay, 30-day readmission, and pulmonary problems. In 27.1% of cases (23/85), pulmonary problems arose. At 90 days, 9.4% (8/85) of the patients died. Worse bone mineral density (odds ratio 0.61; 95% confidence interval 0.39-0.95) was linked to lower survival, longer length of stay (0.83; 0.77-0.89), and readmissions in multivariable analysis (0.39; 0.15-1.00).
Higher lung density 5:lung density 2 volume (1.84; 1.05-3.23) was linked to pulmonary problems and a longer length of stay (1.32; 1.23-1.41), presumably due to scarring, whereas lower subcutaneous fat area: height was linked to readmissions, probably due to a lack of metabolic reserve (0.35; 0.13-0.93). Patients who show symptoms of frailty, such as low bone mineral density, may have a higher chance of negative outcomes, such as a shorter survival time after lung volume reduction surgery. To evaluate whether analytic morphomics might improve risk stratification and patient selection, the findings of this hypothesis-generating investigation will need to be confirmed in bigger, multicenter trials.
Reference:www.semthorcardiovascsurg.com/article/S1043-0679(21)00296-3/fulltext
