Hartmans, M.E. (2019) Muscle Quality as Prognostic Factor for Postoperative Complications after DIEP Flap Breast Reconstruction: a healthy patient population. thesis, Medicine.
Full text available on request.Abstract
Introduction: Research shows that health parameters sarcopenia and decreased muscle radiodensity have negative effects on the postoperative course. They are associated with disability, injuries, hospitalization, mortality and complications. Until now, the effects of these parameters were mostly investigated in elderly and ill patients. What their effects are on relatively healthy individuals who undergo surgery still remains uncertain. Therefore, in this study a new patient group was analyzed: the DIEP flap breast reconstruction (BR) patient. The DIEP flap BR is a major surgery with high complication rate. The aim of this study is to assess new and better prognostic factors for this relatively healthy patient population. Next to muscle characteristics, fat characteristics are evaluated. Methods: This retrospective cohort study was executed at the University Medical Center Groningen. Patient and surgery characteristics were retrieved from the electronic medical record system. Complications were graded using Clavien Dindo grading classification. Muscle and fat indexes and muscle radiodensities were calculated on the cross-sectional CTimage at level L3. With logistic regression, the effects of independent variables were analyzed for postoperative complications. Results: The overall complication rate was 60%, from which 38% of all patients needed medical treatment for the complication. A decrease in muscle radiodensity and radiotherapy increased the occurrence of postoperative complications. In this patient population, the muscle index and fat indexes did not influence postoperative course. Conclusion: Muscle radiodensity is a prognostic factor for this healthy patient population. Muscle mass seems to have no effect on the postoperative course. Better insight about the patients’ individual risk profile leads to better decision making. Additionally, developing a prehabilitation program might be helpful to improve surgical outcome.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Jansen, Dr. L. and University Medical Center Groningen, Department of Surgical |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1290 |
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