Prevalence of skeletal muscle mass loss and its association with swallowing function after cardiovascular surgery

Objective: The aim of this study was to assess the prevalence of skeletal muscle mass loss and its association with swallowing function in patients with dysphagia after cardiovascular surgery. Methods: A retrospective cohort study was performed in 65 consecutive patients with dysphagia after cardiovascular surgery who were prescribed speech therapy. Skeletal muscle index (SMI) was calculated as total psoas muscle area assessed via abdominal computed tomography divided by height squared. Cutoff values were 6.36 cm(2)/m(2) for men and 3.92 cm(2)/m(2) for women. The Food Intake Level Scale (FILS) was used to assess the swallowing function. Univariate and ordered logistic regression analyses were applied to examine the associations between skeletal muscle mass loss and dysphagia. Results: The study included 50 men and 15 women (mean age 73 +/- 8 y). The mean SMI was 4.72 +/- 1.37 cm(2)/m(2) in men and 3.33 +/- 1.42 cm(2)/m(2) in women. Skeletal muscle mass loss was found in 53 (82%) patients. Twelve had tracheostomy cannula. Thirteen were non-oral feeding (FILS levels 1-3), 5 were oral food intake and alternative nutrition (levels 4-6), and 47 were oral food intake alone (levels 7-9) at discharge. The FILS at discharge was significantly lower in patients with skeletal muscle mass loss. Ordered logistic regression analysis of swallowing function showed that skeletal muscle mass loss and tracheostomy cannula were associated independently with the FILS at discharge. Conclusions: The prevalence of skeletal muscle mass loss is very high, and skeletal muscle mass loss is associated with swallowing function. (C) 2017 Elsevier Inc. All rights reserved.