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Sarcopenia defined by a computed tomography estimate of the psoas muscle area does not predict frailty in geriatric trauma patients.
Am J Surg. 2019 08; 218(2):261-265.AJ

Abstract

INTRODUCTION

The aim of our study was to assess the correlation between frailty & sarcopenia and impact of each condition on outcomes in geriatric trauma patients.

METHODS

We performed a four-year (2013-2016) secondary analysis of our prospectively maintained frailty database and included all trauma patients age ≥65 y who had CT-abdomen. Trauma-Specific-Frailty-Index (TSFI) was used to calculate frailty. Patients were classified as non-frail or frail. Sarcopenia was defined as the lowest sex-specific-quartile of total-psoas-index (TPI). Outcome measures included in-hospital complications, mortality and adverse disposition.

RESULTS

325 patients were included in the study, 36% (n = 117) were frail and 24.9% (n = 81) had sarcopenia. There was a weak correlation between frailty and sarcopenia (R2 = 0.04). The overall rate of complications and mortality was 19.4% and 7.7% respectively. On regression analysis, after controlling for possible confounding variables and frailty status, sarcopenia was associated with adverse disposition (OR:1.41,p = 0.01). However, it was not associated with in-hospital complications (OR:1.21,p = 0.54) or in-hospital mortality (OR:1.12,p = 0.73).

CONCLUSION

Sarcopenia as an individual marker might not be an effective screening tool for risk assessment in geriatric-trauma patients. Frailty assessment should be a part of risk assessment and prognostication.

Authors+Show Affiliations

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: ashleymccusker@email.arizona.edu.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: mkhan17@surgery.arizona.edu.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: nkulvatunyou@surgery.arizona.edu.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: mzeeshan@surgery.arizona.edu.Division of Acute Care Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address: jsakran1@jhmi.edu.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: haya.hayek@gmail.com.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: tokeeffe@surgery.arizona.edu.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: hamidi@surgery.arizona.edu.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: atang@surgery.arizona.edu.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: bjoseph@surgery.arizona.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30122406

Citation

Mccusker, Ashley, et al. "Sarcopenia Defined By a Computed Tomography Estimate of the Psoas Muscle Area Does Not Predict Frailty in Geriatric Trauma Patients." American Journal of Surgery, vol. 218, no. 2, 2019, pp. 261-265.
Mccusker A, Khan M, Kulvatunyou N, et al. Sarcopenia defined by a computed tomography estimate of the psoas muscle area does not predict frailty in geriatric trauma patients. Am J Surg. 2019;218(2):261-265.
Mccusker, A., Khan, M., Kulvatunyou, N., Zeeshan, M., Sakran, J. V., Hayek, H., O'Keeffe, T., Hamidi, M., Tang, A., & Joseph, B. (2019). Sarcopenia defined by a computed tomography estimate of the psoas muscle area does not predict frailty in geriatric trauma patients. American Journal of Surgery, 218(2), 261-265. https://doi.org/10.1016/j.amjsurg.2018.07.024
Mccusker A, et al. Sarcopenia Defined By a Computed Tomography Estimate of the Psoas Muscle Area Does Not Predict Frailty in Geriatric Trauma Patients. Am J Surg. 2019;218(2):261-265. PubMed PMID: 30122406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sarcopenia defined by a computed tomography estimate of the psoas muscle area does not predict frailty in geriatric trauma patients. AU - Mccusker,Ashley, AU - Khan,Muhammad, AU - Kulvatunyou,Narong, AU - Zeeshan,Muhammad, AU - Sakran,Joseph V, AU - Hayek,Haya, AU - O'Keeffe,Terence, AU - Hamidi,Mohammad, AU - Tang,Andrew, AU - Joseph,Bellal, Y1 - 2018/08/03/ PY - 2018/06/23/received PY - 2018/07/18/revised PY - 2018/07/20/accepted PY - 2018/8/21/pubmed PY - 2020/1/23/medline PY - 2018/8/21/entrez KW - Frailty KW - Geriatric trauma KW - Geriatrics KW - Level II KW - Prognostic studies KW - Sarcopenia SP - 261 EP - 265 JF - American journal of surgery JO - Am J Surg VL - 218 IS - 2 N2 - INTRODUCTION: The aim of our study was to assess the correlation between frailty & sarcopenia and impact of each condition on outcomes in geriatric trauma patients. METHODS: We performed a four-year (2013-2016) secondary analysis of our prospectively maintained frailty database and included all trauma patients age ≥65 y who had CT-abdomen. Trauma-Specific-Frailty-Index (TSFI) was used to calculate frailty. Patients were classified as non-frail or frail. Sarcopenia was defined as the lowest sex-specific-quartile of total-psoas-index (TPI). Outcome measures included in-hospital complications, mortality and adverse disposition. RESULTS: 325 patients were included in the study, 36% (n = 117) were frail and 24.9% (n = 81) had sarcopenia. There was a weak correlation between frailty and sarcopenia (R2 = 0.04). The overall rate of complications and mortality was 19.4% and 7.7% respectively. On regression analysis, after controlling for possible confounding variables and frailty status, sarcopenia was associated with adverse disposition (OR:1.41,p = 0.01). However, it was not associated with in-hospital complications (OR:1.21,p = 0.54) or in-hospital mortality (OR:1.12,p = 0.73). CONCLUSION: Sarcopenia as an individual marker might not be an effective screening tool for risk assessment in geriatric-trauma patients. Frailty assessment should be a part of risk assessment and prognostication. SN - 1879-1883 UR - https://www.unboundmedicine.com/medline/citation/30122406/Sarcopenia_defined_by_a_computed_tomography_estimate_of_the_psoas_muscle_area_does_not_predict_frailty_in_geriatric_trauma_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(18)30898-5 DB - PRIME DP - Unbound Medicine ER -