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Skeletal Muscle Wasting as Predictor of Future Cystic Fibrosis (CF) Exacerbations
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A2172 - Skeletal Muscle Wasting as Predictor of Future Cystic Fibrosis (CF) Exacerbations
Author Block: A. A. Jaitovich1, B. Saha2, M. M. Khan3, C. Dumas1, J. Fantauzzi4, T. C. Smith5, M. A. Judson6; 1Medicine, Albany Medical College, Albany, NY, United States, 2Pulmonary and Critical Care, Albany Medical Center, Albany, NY, United States, 3Pulmonary/Critical Care Medicine, Albany Medical Center, Albany, NY, United States, 4Radiology, Albany Medical College, Albany, NY, United States, 5Albany Medical College, Albany, NY, United States, 6Div of Pulm/CCM, Albany Medical College, Albany, NY, United States.
Rationale: Exacerbations of CF represent a major cause of progression to end-stage lung disease and death. Accelerated loss of skeletal muscle mass occurs during exacerbations. Although skeletal muscle wasting is associated to lower survival in CF and poor nutritional state predicts future exacerbations, it is unclear if muscle wasting anticipates exacerbations as well. Methods: We hypothesized that more wasted patients would be more prone to CF exacerbations. To test that, we performed a retrospective cohort study of 50 patients with diagnosis of CF and previous performance of a computed tomography (CT) of the chest or abdomen and measured the erector spinal muscle cross sectional area (ESMCSA) at the 12th thoracic level. Outcomes measures were association between ESMCSA and total days of intravenous antibiotics received to treat a severe CF exacerbation within the following 365 days after the CT scan performance, and association between ESMCSA and number of exacerbations occurring in that period. We adjusted for different variables known to predispose to exacerbations including previous exacerbations, vital capacity and previous microbiological isolates. Results: No significant difference was found in the muscle mass among patients who develop exacerbations versus the ones who did not. ESMCSA was 2352 +/- 180 mm2 in non-exacerbators and 2103 +/- 186 mm2 in exacerbators (p=0.76). Even after adjusting for different confounders, the difference remained non-significant. Conclusions: In sharp contrast with our prediction, skeletal muscle mass as reflected by the ESMCSA does not predict future exacerbations of CF in our cohort of patients.
Author Block: A. A. Jaitovich1, B. Saha2, M. M. Khan3, C. Dumas1, J. Fantauzzi4, T. C. Smith5, M. A. Judson6; 1Medicine, Albany Medical College, Albany, NY, United States, 2Pulmonary and Critical Care, Albany Medical Center, Albany, NY, United States, 3Pulmonary/Critical Care Medicine, Albany Medical Center, Albany, NY, United States, 4Radiology, Albany Medical College, Albany, NY, United States, 5Albany Medical College, Albany, NY, United States, 6Div of Pulm/CCM, Albany Medical College, Albany, NY, United States.
Rationale: Exacerbations of CF represent a major cause of progression to end-stage lung disease and death. Accelerated loss of skeletal muscle mass occurs during exacerbations. Although skeletal muscle wasting is associated to lower survival in CF and poor nutritional state predicts future exacerbations, it is unclear if muscle wasting anticipates exacerbations as well. Methods: We hypothesized that more wasted patients would be more prone to CF exacerbations. To test that, we performed a retrospective cohort study of 50 patients with diagnosis of CF and previous performance of a computed tomography (CT) of the chest or abdomen and measured the erector spinal muscle cross sectional area (ESMCSA) at the 12th thoracic level. Outcomes measures were association between ESMCSA and total days of intravenous antibiotics received to treat a severe CF exacerbation within the following 365 days after the CT scan performance, and association between ESMCSA and number of exacerbations occurring in that period. We adjusted for different variables known to predispose to exacerbations including previous exacerbations, vital capacity and previous microbiological isolates. Results: No significant difference was found in the muscle mass among patients who develop exacerbations versus the ones who did not. ESMCSA was 2352 +/- 180 mm2 in non-exacerbators and 2103 +/- 186 mm2 in exacerbators (p=0.76). Even after adjusting for different confounders, the difference remained non-significant. Conclusions: In sharp contrast with our prediction, skeletal muscle mass as reflected by the ESMCSA does not predict future exacerbations of CF in our cohort of patients.
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