Background: It has been reported that the presence of critical limb ischemia (CLI) was strongly associated with mortality.Although several studies showed that sarcopenia was one of the predictors of mortality, an assessment of sarcopeniahas not been enough established. The present study aimsto determine the prognostic value of the Manual Muscle Test (MMT) as the simple marker of sarcopenia status in patients with CLI.
Methods: This study was a single center, retrospective observational study. From January 2013 to March 2017, a total of 139 patients with CLI who underwent endovascular treatment (EVT) were enrolled. To investigate the effect of sarcopenia status on outcomes, patients were distributedinto three MMT groups as follows: MMT 0-2 group (24 patients, 17.3%), MMT 3 group (64 patients, 46%) and MMT 4-5 group (51 patients, 36.7%). Outcome measure was all-cause mortality within two years. Kaplan-Meier survival curves were used to estimate all-cause mortality.
Results: Among 139 patients, the mean age was 75.9 ± 9.4 years and 59 patients were female (42.4%). The overall mean MMT was 3.3 ± 0.9 and mean follow-up period was 484 ± 427 days. There was statistical significant differences about body mass index (20.68, 20.75 VS 22.44 kg/m, P=0.019) and serum albumin (33.8, 34.9 VS 39.0 g/L, P<0.001) in MMT 0-2 group, MMT 3 group and MMT 4-5 group, respectively. However there was no statistical significant differences about total cholesterol (4.3, 4.3 VS 4.3 mmol/L, P=0.80), HbA1C (6.3, 6.7 VS 7.1 NGSP%, P=0.260) and BNP (354.2, 620.8 VS 439.1 pg/mL, P=0.66). Kaplan-Meier survival curve showed thatfreedom from all-cause death at one year was 53.2 %, 69.5 % and 86.4 %, and at two years was 39.9%, 52.2% and 74.5%, respectively.
Conclusion: In patients with CLI, the MMT could assess sarcopenia status and it was a useful tool for predicting early mortality.