Abstract 13941: CT-derived Skeletal Muscle Index: A Novel Predictor of Frailty and Hospital Length of Stay After Transcatheter Aortic Valve Replacement

Introduction: We determined the prevalence of sarcopenia in patients undergoing transcatheter aortic valve replacement (TAVR) and whether skeletal muscle mass measured from preoperative computed tomography (CT) images provides value in predicting post-operative length of stay. Background: There is limited data on the use of body composition as a frailty measure in TAVR patients and no studies have determined if this measure predicts length of stay. Methods: We studied 104 consecutive patients who underwent TAVR at Tallahassee Memorial Hospital from 2012 to 2016. Patient demographics, frailty measures (hand grip, albumin, and 5m walk test), clinical comorbidities and echocardiographic data were recorded. Skeletal muscle index (SMI) [skeletal muscle mass cross-sectional area/height 2 ] was measured from CT images using Slice-O-Matic software (Tomovision, Montreal, Quebec, Canada) (Figure 1). Clinical outcomes were assessed and multivariate methods used to determine predictors of LOS. Results: Sarcopenia was prevalent in men (83%) and women (56%). Only SMI and mitral regurgitation showed a univariate relationship with LOS, while none of the established frailty measures predicted LOS. SMI was correlated with age, gender, BMI, handgrip strength, previous PCI and previous CABG. A multivariate model including age, gender, major complications, BMI, SMI, mitral regurgitation, grip strength and walk test showed only SMI, MR, and major complications as independent predictors of LOS. For every 8.6 cm 2 /m 2 increase in SMI, there was a 1 day reduction in LOS. Conclusions: SMI, a measure of sarcopenia readily determined from pre-TAVR CT scans, independently predicts TAVR LOS better than standard frailty testing. Further evaluation of SMI as a frailty measure after TAVR is warranted.