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Bradley, N.A. and Walter, A. and Wilson, A. and Siddiqui, T. and Roxburgh, C.S.D. and McMillan, D.C. and Guthrie, G.J.K. (2023) The relationship between CT-derived body composition, systemic inflammation, and survival in patients with abdominal aortic aneurysm. Journal of Vascular Surgery, 78 (4). 937-944.e4. ISSN 0741-5214

AI Summary:

Combining measures of radiological sarcopenia and the SIR offers prognostic value in patients undergoing elective intervention for AAA.

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Abstract

Objectives:
Patient selection and risk stratification for elective repair of abdominal aortic aneurysm (AAA), either by open surgical repair (OSR) or endovascular aneurysm repair (EVAR), remains challenging. CT-derived body composition analysis (CT-BC), and systemic inflammation-based scoring systems such as the systemic inflammatory grade (SIG), appear to offer prognostic value in patients with AAA undergoing EVAR. The relationship between CT-BC, systemic inflammation, and prognosis has been explored in patients with cancer, but data in non-cancer populations are lacking. The present study aimed to examine the relationship between CT-BC, SIG, and survival in patients undergoing elective intervention for AAA.

Methods:
611 consecutive patients undergoing elective intervention for AAA at three large tertiary referral centres were retrospectively recruited for inclusion into the study. CT-BC was performed and analysed using the CT-sarcopenia score (CT-SS). Subcutaneous and visceral fat indices (SFI, VFI) were also recorded. SIG was calculated from pre-operative blood tests. The outcomes of interest were overall and 5-year mortality.

Results:
Median (IQR) follow-up was 67.0 (32) months, and there were 194 (32%) deaths during the follow-up period. There were 122 (20%) OSR cases, 558 (91%) males, and a median (IQR) age of 73.0 (11.0) years. Age (HR 1.66, 95% CI 1.28 – 2.14, p <0.001), elevated CT-SS (HR 1.58, 95% CI 1.28 – 1.94, p <0.001), and elevated SIG (HR 1.29, 95% CI 1.07 – 1.55, p <0.01) were independently associated with increased hazard of mortality. Mean (95% CI) survival in the CT-SS 0 & SIG 0 sub-group was 92.6 (84.8 – 100.4) months, compared with 44.9 (30.6 – 59.2) months in the CT-SS 2 & SIG ≥ 2 sub-group (p <0.001). Patients with CT-SS 0 & SIG 0 had 90% (SE 4%) 5-year survival, compared with 34% (SE 9%) in patients with CT-SS 2 & SIG ≥ 2 (p <0.001).

Conclusions:
Combining measures of radiological sarcopenia and the SIR offers prognostic value in patients undergoing elective intervention for AAA and may contribute to future clinical risk predication strategies.

People

Bradley, N.A.

Author

Publications

Bradley, Nicholas A. and Roxburgh, Campbell S.D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) A systematic review of the role of systemic inflammation-based prognostic scores in patients with abdominal aortic aneurysm. Surgeon, 23 (1). e1-e8. ISSN 1479-666X

Bradley, Nicholas A. and Walter, Amy and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell S.D. and Guthrie, Graeme J.K. and McMillan, Donald C. (2025) The relationship between peri-operative systemic inflammation and survival in patients with abdominal aortic aneurysm. Annals of Vascular Surgery, 110 (Part A). pp. 329-339. ISSN 0890-5096

Bradley, Nicholas and Dosanj, Karamonique and Chan, Sharon Yen Ming and Wilson, Alasdair and Siddiqui, Tamim and Forsythe, Rachel and Roxburgh, Campbell S.D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2024) The relationship between CT-derived cervical muscle mass and quality, systemic inflammation, and survival in symptomatic patients undergoing carotid endarterectomy. BJS Open, 8 (5): zrae114. ISSN 2474-9842

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Walter, A.

Author

Publications

Bradley, N.A. and Walter, A. and Roxburgh, C.S.D. and McMillan, D.C. and Guthrie, G.J.K. (2024) The relationship between clinical frailty score, CT-derived body composition, systemic inflammation, and survival in patients with chronic limb threatening ischaemia. Annals of Vascular Surgery, 104. pp. 18-26. ISSN 0890-5096

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Wilson, A.

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Siddiqui, T.

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Roxburgh, Campbell S. D.

Author

Publications

Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991

Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407

Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377