Paraspinous Sarcopenia predictor of prognosis in Geriatric trauma patients: Study

The study was conducted by collecting data from January 2011 to December 2014 of trauma patients who are 65 years and older at a single level 1 trauma centre. Chest and/or abdominal CT imaging obtained were used to determine cross-sectional area of paraspinous and abdominal muscles at the T12 and L3 levels. Skeletal muscle index (SMI) was calculated as cross sectional area divided by height squared (cm2 /m2). Established L3 SMI thresholds were correlated with paraspinous T12 SMI to identify optimal sex-specific sarcopenia thresholds.

The key findings of the study were:

• Out of the 450 patients, 316 (70.2%) had comparable L3 imaging available for T12 threshold development.

• The median age was 75 years and out of these 192 patients (42.7%) were female.

• The correlation between T12 SMI and L3 SMI was strong (ρ = 0.63; P < .001).

• The T12 SMI thresholds with the best model performance were 9.01cm2 /m2 for women and 10.66cm2 /m2 for men.

• Patients were dichotomized into sarcopenic and non sarcopenic groups using these T12 thresholds.

• Short-term outcomes did not differ between sarcopenic and non sarcopenic groups.

• One-year mortality was significantly higher in patients with sarcopenia (34 [16%] vs 7 [3%]; P < .001; hazard ratio, 3.3; 95% CI, 1.3–8.5; P = .01).

Thus, the authors concluded that that paraspinous sarcopenia at the T12 level is a good, widely accessible, surrogate measurement of frailty that may help guide long-term prognostication in geriatric trauma patients following prospective confirmation of utility.