Psoas:lumbar vertebra index: central sarcopenia independently predicts morbidity in elderly trauma patients

Autor: Daniel N. Holena, Jose L. Pascual, C. W. Schwab, Michael G.S. Shashaty, R. Dua, Seema S. Sonnad, Daniel Grabo, Carrie A. Sims, L. Ebbeling
Rok vydání: 2013
Předmět:
Zdroj: European Journal of Trauma and Emergency Surgery
ISSN: 1863-9941
1863-9933
DOI: 10.1007/s00068-013-0313-3
Popis: Introduction Central sarcopenia as a surrogate for frailty has recently been studied as a predictor of outcome in elderly medical patients, but less is known about how this metric relates to outcomes after trauma. We hypothesized that psoas:lumbar vertebral index (PLVI), a measure of central sarcopenia, is associated with increased morbidity and mortality in elderly trauma patients. Methods A query of our institutional trauma registry from 2005 to 2010 was performed. Data was collected prospectively for the Pennsylvania Trauma Outcomes Study (PTOS). Inclusion criteria: age >55 years, ISS >15, and ICU LOS >48 h. Using admission CT scans, psoas:vertebral index was computed as the ratio between the mean cross-sectional areas of the psoas muscles and the L4 vertebral body at the level of the L4 pedicles. The 50th percentile of the psoas:L4 vertebral index value was determined, and patients were grouped into high (>0.84) and low (≤0.83) categories based on their relation to the cohort median. Primary endpoints were mortality and morbidity (as a combined endpoint for PTOS-defined complications). Univariate logistic regression was used to test the association between patient factors and mortality. Factors found to be associated with mortality at p
Databáze: OpenAIRE
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