Automated Muscle Measurement on Chest CT Predicts All-Cause Mortality in Older Adults From the National Lung Screening Trial
| Autor: | Fang-Chi Hsu, Robert D. Boutin, Leon Lenchik, Ashley A. Weaver, Haiying Chen, Stephen B. Kritchevsky, Josh Tan, Ryan T. Barnard, Peggy M. Cawthon |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Aging THE JOURNAL OF GERONTOLOGY: Medical Sciences Lower risk Cohort Studies Machine Learning Multicenter trial Internal medicine medicine Humans Muscle Skeletal Lung Aged Proportional Hazards Models Retrospective Studies Proportional hazards model business.industry Hazard ratio Middle Aged medicine.disease SMA Confidence interval Sarcopenia National Lung Screening Trial Female Geriatrics and Gerontology business Tomography X-Ray Computed |
| Zdroj: | J Gerontol A Biol Sci Med Sci |
| ISSN: | 1758-535X |
| Popis: | Background Muscle metrics derived from computed tomography (CT) are associated with adverse health events in older persons, but obtaining these metrics using current methods is not practical for large datasets. We developed a fully automated method for muscle measurement on CT images. This study aimed to determine the relationship between muscle measurements on CT with survival in a large multicenter trial of older adults. Method The relationship between baseline paraspinous skeletal muscle area (SMA) and skeletal muscle density (SMD) and survival over 6 years was determined in 6,803 men and 4,558 women (baseline age: 60–69 years) in the National Lung Screening Trial (NLST). The automated machine learning pipeline selected appropriate CT series, chose a single image at T12, and segmented left paraspinous muscle, recording cross-sectional area and density. Associations between SMA and SMD with all-cause mortality were determined using sex-stratified Cox proportional hazards models, adjusted for age, race, height, weight, pack-years of smoking, and presence of diabetes, chronic lung disease, cardiovascular disease, and cancer at enrollment. Results After a mean 6.44 ± 1.06 years of follow-up, 635 (9.33%) men and 265 (5.81%) women died. In men, higher SMA and SMD were associated with a lower risk of all-cause mortality, in fully adjusted models. A one-unit standard deviation increase was associated with a hazard ratio (HR) = 0.85 (95% confidence interval [CI] = 0.79, 0.91; p < .001) for SMA and HR = 0.91 (95% CI = 0.84, 0.98; p = .012) for SMD. In women, the associations did not reach significance. Conclusion Higher paraspinous SMA and SMD, automatically derived from CT exams, were associated with better survival in a large multicenter cohort of community-dwelling older men. |
| Databáze: | OpenAIRE |
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