The psoas muscle index as a predictor of mortality and morbidity of geriatric trauma patients: experience of a major trauma center in Kobe

Purpose An association between the prognoses of trauma and sarcopenia has not been well documented. The purpose of this study was to compare the outcomes of elderly Japanese trauma patients with sarcopenia and those without sarcopenia. Methods The medical records of patients aged ≧ 65 years old and...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2020-09, Vol.50 (9), p.1016-1023
Main Authors: Nishimura, Takeshi, Naito, Hiromichi, Fujisaki, Noritomo, Ishihara, Satoshi, Nakao, Atsunori, Nakayama, Shinichi
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Comorbidity
Female
Forecasting
Humans
Japan
Male
Medicine
Medicine & Public Health
Original Article
Prognosis
Psoas Muscles - diagnostic imaging
Psoas Muscles - pathology
Retrospective Studies
Risk
Sarcopenia - diagnosis
Sarcopenia - epidemiology
Sarcopenia - pathology
Surgery
Surgical Oncology
Surveys and Questionnaires
Tomography, X-Ray Computed
Trauma Centers
Trauma Severity Indices
Wounds and Injuries - epidemiology
Wounds and Injuries - mortality
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Summary:Purpose An association between the prognoses of trauma and sarcopenia has not been well documented. The purpose of this study was to compare the outcomes of elderly Japanese trauma patients with sarcopenia and those without sarcopenia. Methods The medical records of patients aged ≧ 65 years old and Injury Severity Scores above 15 treated for trauma between 2010 and 2017 were reviewed, retrospectively. We measured the psoas muscle index (PMI), defined as the psoas muscle area at the third lumbar vertebra level divided by the body surface area. Patients of each gender with a PMI less than the lower interquartile range were included in the sarcopenia group. A questionnaire was mailed to the patients or their families to collect data on 1-year mortality and activities of daily living. Results There were 405 patients included in this study: 304 in the non-sarcopenia group (Group NS) and 101 in the sarcopenia group (Group S). Mortality was significantly higher in Group S than in Group NS (NS; 7.9% vs. S; 15.8%, OR, 2.20; 95% CI, 1.12–4.32; p  = 0.027). Only 175 of the questionnaires were completed and the responses did not reveal any significant differences between the groups. Conclusions Sarcopenia as defined by the PMI may be used as an indicator for mortality risk for geriatric trauma patients.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-020-01980-1