1.Persistent Orthostatic Hypotension Following Surgery for Adult Spinal Deformity: Prevalence, Risk Factors, and Cardiovascular Evaluation
Morito TAKANO ; Tsuyoshi IIDA ; Tomohiro HIKATA
Asian Spine Journal 2023;17(4):685-692
Methods:
We examined medical records from a single central database for 65 patients receiving surgical treatment for ASD. Statistical comparisons were made between patients who experienced postoperative POH and those who did not, by examining patient and operative characteristics, such as age, sex, comorbidities, functional status, preoperative neurological function, vertebral fractures, three-column osteotomy, total operative time, estimated blood loss, length of stay, and radiographic parameters. The determinants of POH were assessed using multiple logistic regression.
Results:
We showed that postoperative POH was a complication of ASD surgery, with a 9% incidence rate. Patients with POH were statistically considerably more likely to require supported walkers due to partial paralysis and to have comorbidities including diabetes and neurodegenerative disease (ND). Furthermore, ND was an independent risk factor for postoperative POH (odds ratio, 4.073; 95% confidence interval, 1.094–8.362; p =0.020). Moreover, perioperative evaluation of the inferior vena cava showed that patients with postoperative POH had preoperative congestive heart failure and had hypovolemia lower postoperative diameter of the inferior vena cava than patients without POH.
Conclusions
Postoperative POH is a potential complication of ASD surgery. The most pertinent risk factor is having an ND. According to our study, patients who have surgery for ASD may experience alterations in their hemodynamics.
2.Sarcopenia affects conservative treatment of osteoporotic vertebral fracture
Hiroki IIDA ; Yoshihito SAKAI ; Tsuyoshi WATANABE ; Hiroki MATSUI ; Marie TAKEMURA ; Yasumoto MATSUI ; Atsushi HARADA ; Tetsuro HIDA ; Kenyu ITO ; Sadayuki ITO
Osteoporosis and Sarcopenia 2018;4(3):95-98
OBJECTIVES: Sarcopenia and osteoporosis affects activities of daily living and quality of elderly people. However, little is known about its impact on elderly locomotor diseases, such as osteoporotic vertebral fracture (OVF). There is no report investigating the influence of both sarcopenia and osteoporosis on outcomes of OVF. This study aimed to evaluate the clinical outcomes of OVF in elderly patients from sarcopenic perspectives. METHODS: This prospective study was conducted with 396 patients, aged 65 years or more, hospitalized for the treatment of OVF (mean age, 81.9 ± 7.1 years; 111 males, 285 females). The primary outcome was the Japanese Orthopaedic Association (JOA) score for lumbar disease (at first visit, hospital discharge, and 1 year after treatment) and Barthel index (at the same time and before hospitalization). The second outcome was living place after discharge. Susceptibility to sarcopenia and osteoporosis were evaluated and clinical results of conservative treatment were compared. RESULTS: Sarcopenia significantly affected Barthel index at first visit and discharge. Sarcopenia patients had significantly higher rate for discharge to nursing home and living in nursing home after 1 year than patients without sarcopenia. Osteoporosis significantly affected the JOA score at the first visit and the Barthel index before hospitalization, at the first visit, discharge, and after 1 year. Osteoporosis did not affect the living place at discharge and after 1 year. CONCLUSIONS: Sarcopenia and osteoporosis affected outcomes of conservative treatment for OVF; moreover, sarcopenia affected the living place of OVF patients at discharge and after 1 year.
Activities of Daily Living
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Aged
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Asian Continental Ancestry Group
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Hospitalization
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Humans
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Male
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Nursing Homes
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Osteoporosis
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Prospective Studies
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Sarcopenia
3.Sex-related differences and cross-sectional age-related changes to the cross-sectional area of the psoas major muscles corrected for fat-free mass
Nozomi OHTA ; Tomomi IIDA ; Yoshihiro HOSHIKAWA ; Yohei TAKATA ; Yoshiharu NAKAJIMA ; Tsuyoshi KOSUGI
Japanese Journal of Physical Fitness and Sports Medicine 2021;70(1):125-132
In the present study, we examined the sex-related differences and cross-sectional age-related changes in the cross-sectional area of the psoas major muscle. The cross-sectional area was corrected for fat-free mass (FFM-corrected), which was calculated as the 2/3rd power of the total fat-free mass. A total of 240 adults (114 men, 126 women, age: 20-81 years) were included in the study. The cross-sectional area of the psoas major muscle was measured by 0.2T magnetic resonance imaging (MRI), and the total fat-free mass was measured by air displacement plethysmography. We demonstrated that the FFM-corrected cross-sectional area of the psoas major muscle was greater in males than females across all age groups. Furthermore, we examined the mean FFM-corrected cross-sectional area of the psoas major muscle across different age groups and demonstrated that it decreased with age. Our findings, when combined with previous results, show a peak in the 20s, which declined with age. Our study revealed sex-related differences and cross-sectional age-related changes in the FFM-corrected cross-sectional area of the psoas major muscle. Our findings also suggest that it is important to define reference values and ranges that take into account age- and sex-related differences when assessing the psoas major muscle by FFM-corrected cross-sectional area.