To evaluate whether reduced psoas major muscle area is associated with short- and long-term mortality following revascularization in patients with peripheral arterial disease (PAD).
Approach:
Systematic Search: A systematic search of MEDLINE, Scopus, and Web of Science identified observational studies assessing psoas muscle morphometrics in adults undergoing surgical or endovascular revascularization for PAD.
Study Inclusion: Seven retrospective cohort studies (n = 2,290 patients) met the inclusion criteria.
Quality Assessment: Study quality was assessed using the NHLBI tool.
Meta-Analysis: Random-effects meta-analyses were performed for 1-month and 1-year mortality.
Key Findings:
Pooled estimate for 1-month mortality suggested a possible increase in early mortality among sarcopenic patients, but this association was not statistically significant (RR = 2.45; 95% CI 0.58–10.36; p = 0.22).
Significant association found between reduced psoas major muscle area and increased 1-year mortality (RR = 2.37; 95% CI 1.51–3.73; p < 0.001).
Confidence intervals were wide, indicating uncertainty regarding the magnitude and consistency of the association across future settings.
Interpretation:
A reduced psoas major muscle area was associated with increased 1-year mortality in patients undergoing lower-limb revascularization for PAD.
Limitations:
Short-term mortality findings were inconclusive due to limited power.
Insufficient data prevented quantitative synthesis of limb outcomes.
Heterogeneity in imaging methodologies and sarcopenia definitions.
Conclusion:
Psoas morphometry may have value in preoperative risk stratification, but standardized definitions and prospective studies are needed.
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