The Impact of Body Mass Composition on Outcome in Multiple Traumatized Patients—Results from the Fourth Thoracic and Third Lumbar Vertebrae: A Single-Center Retrospective Observational Study

Belger, Esref; Truhn, Daniel; Weber, Christian David; Neumann, Ulf; Hildebrand, Frank; Horst, Klemens

doi:10.3390/jcm12072520

Cited by 3 publications

(1 citation statement)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, fat-free mass in the limbs does not correlate with that of the entire body [ 33 ]. Additionally, a recent study reported a significant association between SMI at the L3 level and survival in patients with multiple traumas but not with SMI at the T4 level [ 34 ]. Although previous studies have suggested strong correlations between total muscle mass and the L3, T4, and pectoralis muscles, caution should be exercised when determining the level of cross-sectional area to be used [ 20 , 33 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Muscle Mass Index and Neurological Outcomes of Patients with Out-of-Hospital Cardiac Arrest

Cho,

Kim,

You

et al. 2024

Life

View full text Add to dashboard Cite

Muscle mass depletion is associated with unfavorable outcomes in many diseases. However, its relationship with cardiac arrest outcomes has not been explored. This retrospective single-center study determined the relationship between muscle mass depletion and the neurological outcomes of patients with out-of-hospital cardiac arrest (OHCA) by measuring muscle mass at various locations. Adult patients with OHCA, who were treated with target temperature management, and who underwent abdominal or chest computed tomography (CT) within 3 months of the cardiac arrest were included. Skeletal muscle index (SMI) was measured at the third lumbar vertebra (L3) level, psoas muscle, fourth thoracic vertebra (T4) level, and pectoralis muscle. The Youden index was used to determine a low SMI based on sex-specific cutoff values. The outcome variables were “good neurological outcome” and “survival” at hospital discharge. Multivariable analyses revealed that patients with low T4 SMI level were significantly associated with good neurological outcomes at hospital discharge (odds ratio = 0.26, 95% confidence interval: 0.07–0.88, p = 0.036). However, no significant differences were observed between good neurological outcomes and low SMI at the L3 level and psoas and pectoralis muscles; SMIs were not associated with survival at hospital discharge. T4 level SMI depletion was inversely associated with good neurological outcomes in patients with OHCA. Thoracic muscle depletion may be crucial for predicting the neurological outcomes in patients with OHCA and further investigation in larger prospective study is warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Association between Muscle Mass Index and Neurological Outcomes of Patients with Out-of-Hospital Cardiac Arrest

Cho,

Kim,

You

et al. 2024

Life

View full text Add to dashboard Cite

show abstract

Body composition parameters in initial CT imaging of mechanically ventilated trauma patients: Single‐centre observational study

Meyer,

Dermendzhiev,

Hetz

et al. 2024

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

BackgroundBody composition parameters provide relevant prognostic significance in critical care cohorts and cancer populations. Published results regarding polytrauma patients are inconclusive to date. The goal of this study was to analyse the role of body composition parameters in severely injured trauma patients.MethodsAll consecutive patients requiring emergency tracheal intubation and mechanical ventilation before initial computed tomography (CT) at a level‐1 trauma centre over a 12‐year period (2008–2019) were reanalysed. The analysis included CT‐derived body composition parameters based upon whole‐body trauma CT as prognostic variables for 30‐day mortality, intensive care unit length of stay (ICU LOS) and mechanical ventilation duration.ResultsFour hundred seventy‐two patients (75% male) with a median age of 49 years, median injury severity score of 26 and 30‐day mortality rate of 22% (104 patients) met the inclusion criteria and were analysed. Regarding body composition parameters, 231 patients (49%) had visceral obesity, 75 patients had sarcopenia (16%) and 35 patients had sarcopenic obesity (7.4%). After adjustment for statistically significant univariable predictors age, body mass index, sarcopenic obesity, visceral obesity, American Society of Anesthesiologists classification ≥3, injury severity score and Glasgow Coma Scale ≤ 8 points, the Cox proportional hazard model identified sarcopenia as significant prognostic factor of 30‐day mortality (hazard ratio 2.84; 95% confidence interval 1.38–5.85; P = 0.004), which was confirmed in Kaplan–Meier survival analysis (log‐rank P = 0.006). In a subanalysis of 363 survivors, linear multivariable regression analysis revealed no significant associations of body composition parameters with ICU LOS and duration of mechanical ventilation.ConclusionsIn a multivariable analysis of mechanically ventilated trauma patients, CT‐defined sarcopenia was significantly associated with 30‐day mortality whereas no associations of body composition parameters with ICU LOS and duration of mechanical ventilation were observed.

show abstract

Epicardial adipose tissue defined by initial polytrauma CT of mechanically ventilated trauma patients: retrospective single-center cohort study to predict short-term outcomes

Meyer,

Dermendzhiev,

Kirsten

et al. 2024

Emerg Radiol

View full text Add to dashboard Cite

Purpose Epicardial adipose tissue (EAT) detected by computed tomography (CT) is associated with morbidity and mortality in patients with COVID-19 and other critical care patient cohorts, whereas their prognostic relevance in trauma patients remains unclear. The present study explored associations with four potential short-term outcomes in trauma patients. Methods All consecutive trauma patients requiring emergency tracheal intubation and mechanical ventilation before initial whole-body CT imaging at a level-1 trauma center over a 12-year period (2008–2019) were reanalyzed for this study. EAT was measured semiquantitatively in initial CT and analyzed regarding associations with 24-hour and 30-day mortality using Cox proportional hazard models. In survivors, associations of EAT with intensive care unit length of stay (ICU LOS) and mechanical ventilation duration were analyzed using linear regression analyses. Results Four hundred fifty-five patients (74.7% male) with a median age of 49 years, and a median injury severity score (ISS) of 26 points were analyzed. In univariable analysis, EAT index was significantly associated with 24-hour and 30-day mortality (p = 0.007, and p = 0.013, respectively). After adjustment for significant predictors age, body mass index, and ISS, no significant associations were confirmed (p = 0.622, and p = 0.903, respectively). In a subanalysis of 353 survivors, EAT index was significantly associated with ICU LOS and mechanical ventilation duration in univariable analyses (p = 0.031, and p = 0.014, respectively), but not in multivariable analyses (p = 0.81 and p = 0.46, respectively). Conclusion EAT index was associated with short-term outcomes in severely injured trauma patients, which not remained significant in multivariable analysis, suggesting that its prognostic capability is limited.

show abstract

The Impact of Body Mass Composition on Outcome in Multiple Traumatized Patients—Results from the Fourth Thoracic and Third Lumbar Vertebrae: A Single-Center Retrospective Observational Study

Cited by 3 publications

References 40 publications

Association between Muscle Mass Index and Neurological Outcomes of Patients with Out-of-Hospital Cardiac Arrest

Association between Muscle Mass Index and Neurological Outcomes of Patients with Out-of-Hospital Cardiac Arrest

Body composition parameters in initial CT imaging of mechanically ventilated trauma patients: Single‐centre observational study

Epicardial adipose tissue defined by initial polytrauma CT of mechanically ventilated trauma patients: retrospective single-center cohort study to predict short-term outcomes

Contact Info

Product

Resources

About