Prins, S.N. (2015) De correlatie tussen de skeletspiermassa en/of skeletspierkwaliteit en de preoperatief gemeten anaerobe drempel bij patiënten die colorectale chirurgie ondergaan. thesis, Medicine.
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Abstract
Background: There is proved that the anaerobic threshold, measured by the cardiopulmonary exercise test (CPET), and the skeletal muscle mass and skeletal muscle quality measured on the preoperative CT-scan are independent predictors for the chance of postoperative complications after major abdominal surgery. However, the CPET is quite complex and an additional examination for the patient. Objective: This study investigates the correlation between CPET variables and the skeletal muscle mass and/or skeletal muscle quality. The aim of this study is to investigate if the CPET variables are predictable through the skeletal muscle mass and/or –quality or preoperative patient characteristics. If so the CPET might be left out for the prediction of postoperative complication risk by major abdominal surgery. Patients and methods: Data of patients ≥60 years old with colorectal cancer who have performed a preoperative CPET and whose preoperative CT-scan was available were included. The CPET is performed preoperative on a cycle ergometer. Skeletal muscle mass was measured as total psoas area (TPA) and total abdominal muscle area (TAMA) on the preoperative CT-scan at the level of the third lumbar vertebra. Skeletal muscle quality was measured using corresponding mean Houndsfield Units (HU) for TAMA. Univariate and multivariate analyses were performed. Results: Data of 48 patients were included. There was a significant but moderate correlation between a decreased absolute anaerobic threshold and a decreased TAMA (R2=10,4%; R2=17,2%) and between a decreased relative anaerobic threshold and a decreased HU of the TAMA (R2=12,4%; R2=15,5%). There was a moderate correlation between a decreased absolute peak oxygen uptake (VO2peak) and a decreased TAMA (R2=23,8%), between a decreased oxygen uptake efficiency slope (OUES) and a decreased TAMA (R2=18%) and between a decreased relative VO2peak and decreased HU of the TAMA (R2=18%). Age, height and TAMA together were the most relevant predictors for the anaerobic threshold (R2 = 43,5%), absolute VO2peak (R2 = 53,5%) and OUES (R2 = 51,6%). The best predictors for the chance of a low anaerobic threshold (≤10 mL/kg/min) were body mass index (BMI) (OR 1,5; P=0,009) and TAMA (OR 0,8; P=0,007). Conclusions: The univariate correlations between the anaerobic threshold and the skeletal muscle mass and –quality seem not to be of clinical relevance. Based on these results and the fact that this is the first study that investigated this, it cannot be assumed that the CPET variables can be predicted through the skeletal muscle mass or –quality or other preoperative patient characteristics.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Klaase, Dr. J.M. chirurg Afdeling: Gastro-intestinale en onc |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2105 |
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