Computed tomography measured psoas density predicts outcomes in trauma

Area of Science:

• Gerontology
• Trauma Surgery
• Radiology

Background:

• Sarcopenia, the age-related loss of muscle mass and function, is associated with adverse outcomes following trauma and surgery.
• Computed tomography (CT) offers a method to assess muscle density and area, potentially predicting patient prognosis.

Purpose of the Study:

• To evaluate the utility of CT-measured psoas muscle density and area as predictors of outcomes in patients with blunt traumatic injury.
• To determine if these readily available bedside measurements can identify patients at risk for poor prognosis.

Main Methods:

• A retrospective cohort study included 151 patients aged ≥45 years who received abdominal/pelvic CT scans with contrast.
• Psoas Index and Hounsfield unit (HU) average were measured at the L3 vertebral level.
• Outcomes analyzed included 90-day mortality, complications, prolonged hospital stay (≥7 days), and discharge disposition.

Main Results:

• The lowest quartile of psoas muscle density (HU average) was significantly associated with increased 90-day mortality (RR 5.95, P < .008).
• Lower psoas muscle density also predicted higher complication risk (RR 2.30, P = .002), longer duration of stay (RR 1.63, P = .048), and dependent discharge (RR 2.14, P = .015).
• The Psoas Index was only significantly associated with 90-day mortality.

Conclusions:

• Psoas muscle density, assessed via CT, is a significant and objective predictor of adverse outcomes in patients with traumatic injuries.
• This measure of sarcopenia can aid clinicians in identifying at-risk patients for targeted nutritional and physical therapy interventions.
• Early identification and intervention can potentially improve patient prognosis, reduce recurrent injuries, and facilitate discharge planning.