SRS216 - Impact of preoperative sarcopenia on in-hospital mortality and spinal cord ischaemia following thoracoabdominal aortic repair (TAAA)

Abstract Objectives Sarcopenia, defined as loss of skeletal mass and strength, is a quantifiable marker for frailty.This study evaluated whether sarcopenia can predict postoperative outcomes in patients undergoing thoracoabdominal aortic repair (TAAA). Methods We retrospectively analysed an institutional dataset of 232 patients who underwent open TAAA repair between 2008–2017. Preoperative computed tomography imaging was available for 88 patients and was assessed for sarcopenia. Variables included in the analysis were gender, age, body mass index, hypertension, diabetes, EuroSCORE, postoperative complications, length of hospital stay and mortality. Results We analysed male and female subgroups separately, as gender is known to affect body composition parameters. In the female subgroup, in-hospital survival in sarcopenic patients was significantly lower than without sarcopenia (P = 0.013, Fig. 1); with a lower mean survival of 67 days versus 96 days, respectively. Univariate analysis identified that sarcopenia (P = 0.016), redo-surgery (P = 0.0001) and postoperative spinal cord ischaemia (P = 0.001), paraplegia (P = 0.0001) and haemofiltration (P = 0.035) all significantly influenced in-hospital mortality. Following multivariate analysis, postoperative haemofiltration and sarcopenia maintained their association with mortality. In the male subgroup, sarcopenia did not influence patient outcomes.Following univariate analysis, we identified that age, hypertension, and postoperative stroke significantly affected in-hospital mortality in this group. Conclusions Sarcopenia correlates with poor survival outcomes and higher in-hospital mortality in female patients undergoing TAAA repair. Although this correlation was not observed in the male subgroup, this preliminary study indicates that sarcopenia is a valuable tool in assessing preoperative frailty, which can enhance perioperative risk stratification in patients undergoing TAAA repair.