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