Role of the psoas muscle thickness-to-height ratio in predicting pulmonary complications and 30-day mortality after liver transplantation

The aim of this study was to investigate the role of psoas muscle thickness to height (PMTH) in predicting pulmonary complications and 30-day mortality after liver transplantation. We compared baseline characteristics between the groups with and without postoperative pulmonary complications (PPCs) and analyzed the risk factors for PPCs and 30-day mortality. A receiver operating characteristic (ROC) curve was used to assess the predictive value of the PMTH on for the incidences of PPCs and 30-day mortality. The optimal cutoff value of the PMTH was applied to compare the PPC and 30-day mortality rates, length of hospital stay, length of intensive care unit (ICU) stay, and postoperative mechanical ventilation time between the low PMTH group and the high PMTH group. Among the 207 patients, 80 (38.6 %) developed PPCs after surgery, and 23 (11.1 %) died within 30 days post-surgery. Patients with PPCs had lower PMTH values (12.5 vs. 18.4, P < 0.001) and albumin levels (36.0 vs. 38.4, P = 0.018) compared with those without PPCs. Multivariate analysis indicated that the PMTH [OR = 0.780, 95 % CI: (0.721–0.844), P < 0.001] was an independent risk factor for mortality after liver transplantation but not for 30-day mortality (P = 0.252). ROC curve analysis revealed that the PMTH had good predictive value for PPCs (area under the curve = 0.793; sensitivity = 0.775; specificity = 0.685; P < 0.001) but had limited predictive value for 30-day mortality after liver transplantation (P = 0.074). Compared with the PMTH ≥15.8 group, the PMTH <15.8 group had a greater incidence of PPCs, longer postoperative hospital stays, and longer ICU stays. The PMTH has good predictive value for PPCs after liver transplantation but cannot predict short-term mortality.