Objective Palliative care aims to enhance the quality of life for patients with life-limiting illnesses. Prognostic assessment in older adults receiving palliative care is difficult due to varied disease progressions and frailty. Although inflammatory biomarkers like the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein-to-albumin ratio (CAR) have been suggested as mortality predictors, their reliability might be limited in palliative settings. Temporal muscle thickness (TMT), a radiological marker of sarcopenia and frailty, may serve as a more consistent prognostic indicator. Methods This retrospective observational study included 134 non-cancer patients aged 60 years or older admitted to a palliative care unit. Patients’ age, gender, type of hospital admission, comorbidities, baseline laboratory parameters, length of stay and 3-month mortality status were recorded. TMT was measured from cranial CT scans obtained within 1 month of admission. Baseline CAR and NLR values were calculated. The primary outcome was 3-month all-cause mortality. Receiver operating characteristic analysis and multivariable logistic regression were used to evaluate prognostic performance. Results Out of 134 patients, 69 (51.5%) died within 3 months. Non-survivors had significantly lower TMT and higher CAR and NLR values. TMT showed the most remarkable ability to predict mortality (area under the curve (AUC)=0.759), surpassing CAR (AUC=0.622) and NLR (AUC=0.610). In multivariable analysis, TMT remained independently associated with mortality, whereas CAR and NLR were not. Conclusion TMT is a strong and independent predictor of short-term mortality in older, non-cancer palliative care patients. TMT may serve as a practical and reliable tool for prognostic assessment in geriatric palliative care.
Borazan et al. (Thu,) studied this question.
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