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. 2021 Dec 28;16(1):359.
doi: 10.1186/s13019-021-01742-1.

Age-dependent differences in the prognostic relevance of body composition-related variables in type A aortic dissection patients

Zeng-Rong Luo #  1   2 , Xiao-Dong Chen #  1   2 , Liang-Wan Chen  3   4
Affiliations

Age-dependent differences in the prognostic relevance of body composition-related variables in type A aortic dissection patients

Zeng-Rong Luo et al. J Cardiothorac Surg. .

Abstract

Background: The current research is allocated to appraise the association between the parameters of body composition and findings in type A aortic dissection (TAAD) cases in diverse age groups.

Methods: Data from consecutive TAAD patients undergoing implantation of modified triple-branched stent-graft from January 2017 and December 2019 were prospectively collected and analyzed. A regression model of Cox proportional hazard was employed to assess correlations among body composition-related variables (body mass index [BMI], lean body mass [LBM], body surface area [BSA], and LBM index) as well as cumulative mortality.

Results: Overall, 258 patients (53.9 ± 11.1 years old; 72.9% male) were separated into young (n = 110) and elderly (n = 148) age groups based upon whether they were younger or older than 50 years of age. Of these patients, 247 survivors were included in subsequent analyses over an average 26.8 ± 11.6 month follow-up duration. Multivariate analyses in the elderly group instead of young group indicated that increased BMI (p = 0.042), BMI ≤ 18.5 kg/m2 (p = 0.025), and lower LBM index values (p = 0.019) were significant predictors of increased total all-cause cumulative mortality. BMI was considerably positively correlated with estimated all-cause cumulative mortality in elderly but not young TAAD cases.

Conclusion: Briefly, these results suggest that BMI and LBM indices are only significant predictors of TAAD patient all-cause mortality in elderly patient cohorts, whereas they do not offer significant prognostic value for younger patients. As such, these age differences must be taken into consideration when conducting stratified risk assessments based upon TAAD patient body composition characteristics.

Keywords: Age; BMI; Body composition parameters; Type A aortic dissection.

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Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the screening and enrollment of study patients
Fig. 2
Fig. 2
Procedure details of implantation of modified triple-branched stent-graft. A Modified triple-branched stent-graft. B Aortic root reconstruction and ascending aortic artificial blood vessel replacement. C Expose the branching arteries in the aortic arch. D Implant and release the modified triple-branched stent-graft. E Two branch stent grafts were fixed as appropriate. F A perfusion tube was inserted into the left carotid artery via the second branch stent graft, and bilateral antegrade cerebral perfusion was performed. G The artificial blood vessel was continuously sutured with the proximal end of the modified triple-branched stent graft
Fig. 3
Fig. 3
Overall all-cause mortality stratified by normal weight, overweight, and obese for young patients (A) and for elderly patients (B) and stratified by obesity versus normal weight for young patients (C) and for elderly patients (D)
Fig. 4
Fig. 4
Association between body mass index and estimated all-cause mortality for elderly patients
See this image and copyright information in PMC

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