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Chen D, Yuan Z, Guo Y, Mo W, Liu W, Liang D, Chen A, Zhang Y, Zhang N, Wei X. Prognostic Impact of Quantifying Sarcopenia and Adipopenia by Chest CT in Severe Aplastic Anemia Patients Treated With Allogeneic Hematopoietic Stem Cell Transplantation. Acad Radiol 2023; 30:1936-1945. [PMID: 36379814 DOI: 10.1016/j.acra.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/24/2022] [Accepted: 10/17/2022] [Indexed: 11/15/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate the prognostic role of chest CT-defined sarcopenia and adipopenia in severe aplastic anemia (SAA) patients treated with hematopoietic stem cell transplantation (HSCT). MATERIALS AND METHODS This was a retrospective study of 123 consecutive SAA patients treated with HSCT. CT imaging was performed to quantify the pectoralis muscle (including major and minor) index (PMI) and the corresponding subcutaneous adipose tissue index (SAI). Sarcopenia and adipopenia were defined as PMI and SAI lower than the respective sex-specific medians. Correlations of the PMI and SAI with anthropometric indexes were calculated. Transplant-related outcomes were compared between the sarcopenia and adipopenia groups. Prognostic factors for overall survival (OS) and fail-free survival (FFS) were identified by Cox regression and were used to create a nomogram. The accuracy of the nomogram was evaluated by ROC curves. RESULTS PMI showed good correlation with BMI and fat-free mass index (p < 0.001). SAI correlated with BMI and fat mass index (p < 0.001). The sarcopenia group (47.2%) had a significantly worse 3-year OS (90.8% vs. 77.6%, p = 0.045) and 3-year FFS (89.2% vs. 74.1%, p = 0.035) than the nonsarcopenia group. Sarcopenia status and diagnostic category were used to construct the nomogram of OS, as these were independent prognostic factors in the multivariate analysis for OS and FFS (p < 0.05). The area under the curve of the nomogram at one year and three years was 0.801 and 0.721, respectively. CONCLUSION Sarcopenia indicates a poor prognosis in SAA patients undergoing HSCT. Intensive supportive care is suggested for SAA patients with sarcopenia before transplantation.
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Affiliation(s)
- Dandan Chen
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China; First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China
| | - Zhaohu Yuan
- Department of Blood Transfusion, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Yuan Guo
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Wenjian Mo
- Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Weifeng Liu
- Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Dan Liang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Amei Chen
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Yan Zhang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Nianru Zhang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Rd, Yuexiu District, Guangzhou, 510180, Guangdong, China; First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China.
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Sun L, Ma H, Du G, Fan D, Liu J, Wang X, Zhang W, Liu B, Yin F. Low Skeletal Muscle Area at the T12 Paravertebral Level as a Prognostic Marker for Community-Acquired Pneumonia. Acad Radiol 2022; 29:e205-e210. [PMID: 35094949 DOI: 10.1016/j.acra.2021.12.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/10/2021] [Accepted: 12/22/2021] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to investigate whether the dorsal skeletal muscle area at 12th thoracic level (T12SMA) could be used as a predictor of in-hospital mortality and long-term survival among patients with community-acquired pneumonia (CAP). MATERIALS AND METHODS A retrospective study was conducted on 1701 CAP patients who underwent chest computed tomography (CT) examinations at the First Hospital of Qinhuangdao. The primary outcome was in-hospital mortality. The T12SMA was analyzed. Multivariate regression logistic models were constructed to identify the prognostic markers of hospital mortality. Cox regression logistic models were constructed to identify the risk factors of long-term survival. RESULTS The multiple logistic regression analysis showed that T12SMA [odds ratio (OR) = 0.946; p = 0.007], CURB-65 (OR = 1.521; p = 0.008), creatinine (OR = 1.003; p = 0.001), albumin (OR = 0.908; p = 0.001) and intensive care unit (ICU) (OR = 2.715; p = 0.007) were independent risk factors for predicting the in-hospital mortality. The cox regression logistic analysis showed that T12SMA (OR = 0.968; p = 0.000), age (OR= 1.036; p = 0.000), sex (OR= 1.435; p = 0.002), CURB-65 (OR = 1.311; p = 0.000), albumin (OR = 0.952; p = 0.000), creatinine (OR = 1.002; p = 0.000) and ICU (OR = 1.606; p = 0.001) were prognostic markers of long-term survival. CONCLUSION T12SMA, CURB-65, creatinine, albumin and ICU were independent risk factors for in-hospital mortality among patients with CAP. And low T12SMA affected the in-hospital mortality and long-term survival of patients with CAP.
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Affiliation(s)
- Lina Sun
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Huifang Ma
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Guohui Du
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Dongmei Fan
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Junru Liu
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Xing Wang
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Weinan Zhang
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Bowei Liu
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China
| | - Fuzai Yin
- Department of Internal Medicine (L.S., F.Y.), Hebei Medical University, Zhongshan Road, Shijiazhuang, Hebei, 050010, People's Republic of China; Department of Internal Medicine (H.M.), Chengde Medical College, Chengde, Hebei, People's Republic of China; Department of Endocrinology (G.D., D.F., J.L., X.W., W.Z., B.L.), The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China.
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