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Sarcopenia and frailty in elderly trauma patients. World J Surg 2015 Feb;39(2):373-9

Date

09/25/2014

Pubmed ID

25249011

Pubmed Central ID

PMC5215219

DOI

10.1007/s00268-014-2785-7

Scopus ID

2-s2.0-84922074209   52 Citations

Abstract

BACKGROUND: Sarcopenia describes a loss of muscle mass and resultant decrease in strength, mobility, and function that can be quantified by CT. We hypothesized that sarcopenia and related frailty characteristics are related to discharge disposition after blunt traumatic injury in the elderly.

METHODS: We reviewed charts of 252 elderly blunt trauma patients who underwent abdominal CT prior to hospital admission. Data for thirteen frailty characteristics were abstracted. Sarcopenia was measured by obtaining skeletal muscle cross-sectional area (CSA) from each patient's psoas major muscle using Slice-O-Matic(®) software. Dispositions were grouped as dependent and independent based on discharge location. χ (2), Fisher's exact, and logistic regression were used to determine factors associated with discharge dependence.

RESULTS: Mean age 76 years, 49 % male, median ISS 9.0 (IQR = 8.0-17.0). Discharge destination was independent in 61.5 %, dependent in 29 %, and 9.5 % of patients died. Each 1 cm(2) increase in psoas muscle CSA was associated with a 20 % decrease in dependent living (p < 0.0001). Gender, weakness, hospital complication, and cognitive impairment were also associated with disposition; ISS was not (p = 0.4754).

CONCLUSIONS: Lower psoas major muscle CSA is related to discharge destination in elderly trauma patients and can be obtained from the admission CT. Lower psoas muscle CSA is related to loss of independence upon discharge in the elderly. The early availability of this variable during the hospitalization of elderly trauma patients may aid in discharge planning and the transition to dependent living.

Author List

Fairchild B, Webb TP, Xiang Q, Tarima S, Brasel KJ

Authors

Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Travis P. Webb MD, MHPE Associate Dean, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Cognition Disorders
Female
Frail Elderly
Home Care Services
Hospital Mortality
Humans
Male
Middle Aged
Muscle Weakness
Nursing Homes
Organ Size
Patient Discharge
Psoas Muscles
Radiography, Abdominal
Rehabilitation Centers
Residence Characteristics
Retrospective Studies
Risk Factors
Sarcopenia
Skilled Nursing Facilities
Tomography, X-Ray Computed
Wounds, Nonpenetrating
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0