Key result
Sarcopenia linked to ~61% higher in-hospital mortality in geriatric blunt trauma patients.
Why the study?
Elderly trauma patients have higher morbidity and mortality linked to frailty, but existing frailty indices are often not feasible to collect; sarcopenia is a reliable objective frailty measure assessable by CT imaging.
Does sarcopenia increase the risk of adverse outcomes in geriatric blunt trauma patients?
Cohort (n=1,175)
Does sarcopenia increase the risk of adverse outcomes in geriatric blunt trauma patients?
Odds Ratio: 1.61 (95% CI 1.01–2.56)
Sarcopenia, measured objectively via CT imaging, is a significant predictor of in-hospital mortality and adverse discharge outcomes in geriatric blunt trauma patients.
Sarcopenia assessment may aid risk stratification in geriatric blunt trauma; leaves open whether interventions targeting it improve outcomes.
Elderly patients are at a higher risk of morbidity and mortality after trauma, which is reflected through higher frailty indices. Data collection using existing frailty indices is often not possible because of brain injury, dementia, or inability to communicate with the patient. Sarcopenia is a reliable objective measure for frailty that can be readily assessed in CT imaging. In this study, we aimed to evaluate the effect of sarcopenia on the outcomes of geriatric blunt trauma patients. Left psoas area (LPA) was measured at the level of the third lumbar vertebra on the axial CT images. LPA was normalized for height (LPA mm2/m2) and after stratification by gender, sarcopenia was defined as LPA measurements in the lowest quartile. A total of 1175 patients consisting of 597 males and 578 females were studied. LPAs below 242.6 mm2/m2 in males and below 187.8 mm2/m2 in females were considered to be sarcopenic. We found sarcopenia in 149 males and 145 females. In multivariate analysis, sarcopenia was associated with a higher risk of in-hospital mortality (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.01-2.56) and a higher risk of discharge to less favorable destinations (OR: 1.42, 95% CI: 1.05-1.97). Lastly, sarcopenic patients had an increased risk of prolonged hospitalization (hazard ratio: 1.21, 95% CI: 1.04-1.40).
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Malekpour et al. (2017) conducted a cohort in Geriatric blunt trauma (n=1,175). Sarcopenia vs. Absence of sarcopenia was evaluated on In-hospital mortality (OR 1.61, 95% CI 1.01-2.56). Sarcopenia was associated with a higher risk of in-hospital mortality (OR 1.61; 95% CI 1.01-2.56) and discharge to less favorable destinations in geriatric blunt trauma patients.
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