Trauma/Critical careComputed tomography measured psoas density predicts outcomes in trauma
Section snippets
Data source and patient characteristics
We reviewed the Ohio State University Trauma Registry for patients aged ≥45 years with blunt mechanism of trauma that underwent evaluation between January 1, 2008 and December 31, 2008 with CT abdomen/pelvis with venous contrast during the initial trauma evaluation. For each patient record, detailed clinical variables were collected including age, sex, body mass index (BMI), independent status before trauma, mechanism of trauma, presenting Glasgow Coma Scale Score, Injury Severity Score, number
Baseline patient characteristics
We stratified patients into interquartile ranges based on either their psoas area or psoas density (Supplementary Table I). Our muscle density cutoff for sarcopenia was defined as the 25th percentile value of HUAC (sarcopenia by HUAC ≤38.5 HU). Given the significant sex-specific difference in PI, our muscle size specific cutoff was defined as the 25th percentile value of PI by sex (sarcopenia by PI, male ≤7.77 cm2/m2, female ≤4.75 cm2/m2). We categorized complications by a set list (
Discussion
Frailty is recognized as a significant contributor to age-related morbidity and mortality. However, there remains no standardized definition or method to identify the representative pathologic loss of physiologic reserve. Current methods often rely on measures in the patient history and functional tests that are reliant on patient effort. The subjective nature and variability of these metrics, as well as the time-consuming nature in gathering them may limit their clinical utility.4, 5, 6, 7
References (28)
- et al.
Frailty as a predictor of surgical outcomes in older patients
J Am Coll Surg
(2010) - et al.
Sarcopenia and mortality after liver transplantation
J Am Coll Surg
(2010) - et al.
Inclusion of sarcopenia outperforms the modified frailty index in predicting 1-year mortality among 1,326 patients undergoing gastrointestinal surgery for a malignant indication
J Am Coll Surg
(2016) - et al.
A quantitative tool to assess degree of sarcopenia objectively in patients with hypercortisolism
Surgery
(2011) - et al.
The fatty degeneration of lumbar paraspinal muscles on computed tomography scan according to age and disc level
Spine J
(2017) - et al.
Preparing the patient for surgery to improve outcomes
Best Pract Res Clin Anaesthesiol
(2016) - et al.
Failure to regain function at 3 months after acute hospital admission predicts institutionalization within 12 months in older patients
J Am Med Dir Assoc
(2012) - et al.
Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: a randomized controlled trial
Am J Med
(2015) - et al.
Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial
J Am Med Dir Assoc
(2012) - et al.
Effect of beta-hydroxy-beta-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults
Clin Nutr
(2013)
Efficacy of beta-hydroxy-beta-methylbutyrate supplementation in elderly and clinical populations
Nutrition
Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: a randomized clinical trial
Clin Nutr
Sarcopenia: origins and clinical relevance
J Nutr
Frailty in older adults: evidence for a phenotype
J Geron
Cited by (0)
T.Y. is the recipient of National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number NIH T32AI 106704-01A1. W.L. is the recipient of an Ohio State University College of Medicine Roessler Research Scholarship.