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- W2888558225 abstract "Frailty and sarcopenia are related but independent conditions common in older patients that can be used to assess their ability to tolerate the stress of major vascular surgery. However, it is unclear whether frailty or sarcopenia is more predictive of surgical outcomes. We assessed the association of frailty and sarcopenia with long-term survival among patients undergoing surgical and nonsurgical management of vascular disease. We retrospectively reviewed all patients who underwent prospective frailty assessment during their vascular surgery clinic visit using the Clinical Frailty Scale between December 2015 and August 2017 and who also underwent an abdominal computed tomography (CT) scan within the preceding 12-month period. The cross-sectional area of skeletal muscle was measured on a single axial CT image at the L3 vertebra. Sarcopenia was defined by established criteria of <52.4 cm2/m2 for men and <38.5 cm2/m2 for women. After patients were stratified by frailty and sarcopenia diagnoses along with comorbidities, the association with all-cause mortality was analyzed using Kaplan-Meier curves and Cox regression models. A total of 415 patients underwent both frailty and sarcopenia assessment; 112 (27%) met only sarcopenia criteria, 48 (12%) met only frailty criteria, and 56 (13%) were both sarcopenic and frail, whereas 199 (48%) controls did not meet criteria for either condition. A vascular procedure was performed on 167 (40%) patients, whereas 248 (60%) were managed nonoperatively with a median (interquartile range) follow-up after CT imaging of 1.5 (1.1-2.2) years. Patients diagnosed with either sarcopenia or frailty were older (mean, 65 years vs 59 years; p < .01) and more likely to be male (69% vs 54%; P < .01) compared with control patients. Long-term survival was significantly decreased for patients diagnosed with either frailty alone or both frailty and sarcopenia who underwent both surgical (Fig, A) and nonsurgical management (Fig, B). In multivariate regression models, frailty was the only independent variable (hazard ratio, 7.7; 95% confidence interval, 3.2-18.7; P < .001) that predicted mortality. Although frailty and sarcopenia have both been used to predict long-term survival among vascular patients, our data indicate that frailty alone is the only independent predictor associated with mortality." @default.
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- W2888558225 date "2018-09-01" @default.
- W2888558225 modified "2023-10-18" @default.
- W2888558225 title "Prognostic Implications of Diagnosing Frailty and Sarcopenia in Vascular Surgery Practice: Form Versus Function" @default.
- W2888558225 doi "https://doi.org/10.1016/j.jvs.2018.06.079" @default.
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