Journal of Cardiothoracic and Vascular Anesthesia · Sep 6, 2025

Exploring the Role of Computer Tomography-Derived Psoas Muscle Volume in Frailty Screening and Sarcopenia Assessment for Older Adult Patients Undergoing Transcatheter Aortic Valve Implantation

By Vollmer T, Steins L, Zabel R et al.

OBJECTIVES: This study evaluates the potential of the computed tomography-derived total psoas volume index (TPVI) as a screening tool for frailty and investigates the relationship between sarcopenia, defined by the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, and postoperative outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). Given the impact of frailty and sarcopenia on complications and mortality, and the lack of standardized screening tools, TPVI may be useful in clinical assessment. DESIGN: A retrospective, single-center study. SETTING: Institute for Anesthesiology and Pain Therapy at the Heart and Diabetes Center NRW, Bad Oeynhausen. PARTICIPANTS: Cohort of 197 patients (≥65 years) undergoing elective TAVI between July 2020 and December 2021. MEASUREMENTS AND MAIN RESULTS: Frailty was assessed using the Fried phenotype, and sarcopenia was determined based on EWGSOP criteria (TPVI, handgrip strength, timed up-and-go test) to form a comprehensive score. Postoperative outcomes, including complications and 1-year mortality, were recorded. Statistical analyses included a fourfold table, receiver operating characteristic curves, Kaplan-Meier survival analysis, and multivariate tests. TPVI demonstrated high specificity (84%) but low sensitivity (28%) in detecting frailty. The area under the curve for predicting frailty was 0.384 for males and 0.393 for females. Sarcopenia was not significantly associated with immediate postoperative complications but was linked to increased 1-year mortality (log-rank test, p = 0.026). CONCLUSIONS: While TPVI is not suitable as a frailty screening tool due to its low sensitivity, it may assist in identifying non-frail patients and optimizing resource allocation. Sarcopenia was significantly associated with higher 1-year mortality, emphasizing the need for multifaceted assessments in older TAVI patients.

doi.org/10.1053/j.jvca.2025.09.007 Open access PubMed 41109757 Biomarkers