The association of radiologic body composition parameters with clinical outcomes in level-1 trauma patients.
Automatic segmentation
Body composition
Complications
Computed tomography
Trauma
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
15
08
2022
accepted:
19
02
2023
medline:
25
8
2023
pubmed:
3
3
2023
entrez:
2
3
2023
Statut:
ppublish
Résumé
The present study aims to assess whether CT-derived muscle mass, muscle density, and visceral fat mass are associated with in-hospital complications and clinical outcome in level-1 trauma patients. A retrospective cohort study was conducted on adult patients admitted to the University Medical Center Utrecht following a trauma between January 1 and December 31, 2017. Trauma patients aged 16 years or older without severe neurological injuries, who underwent a CT that included the abdomen within 7 days of admission, were included. An artificial intelligence (AI) algorithm was used to retrieve muscle areas to calculate the psoas muscle index and to retrieve psoas muscle radiation attenuation and visceral fat (VF) area from axial CT images. Multivariable logistic and linear regression analyses were performed to assess associations between body composition parameters and outcomes. A total of 404 patients were included for analysis. The median age was 49 years (interquartile range [IQR] 30-64), and 66.6% were male. Severe comorbidities (ASA 3-4) were seen in 10.9%, and the median ISS was 9 (IQR 5-14). Psoas muscle index was not independently associated with complications, but it was associated with ICU admission (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.65-0.95), and an unfavorable Glasgow Outcome Scale (GOS) score at discharge (OR 0.62, 95% CI 0.45-0.85). Psoas muscle radiation attenuation was independently associated with the development of any complication (OR 0.60, 95% CI 0.42-0.85), pneumonia (OR 0.63, 95% CI 0.41-0.96), and delirium (OR 0.49, 95% CI 0.28-0.87). VF was associated with developing a delirium (OR 1.95, 95% CI 1.12-3.41). In level-1 trauma patients without severe neurological injuries, automatically derived body composition parameters are able to independently predict an increased risk of specific complications and other poor outcomes.
Identifiants
pubmed: 36862245
doi: 10.1007/s00068-023-02252-6
pii: 10.1007/s00068-023-02252-6
pmc: PMC10449658
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1947-1958Informations de copyright
© 2023. The Author(s).
Références
World J Surg. 2020 Jun;44(6):1817-1823
pubmed: 32006135
Eur J Trauma Emerg Surg. 2021 Aug;47(4):1089-1103
pubmed: 31745608
J Surg Res. 2018 Jan;221:161-166
pubmed: 29229123
Eur Surg Res. 2018;59(1-2):23-34
pubmed: 29393202
Int J Obes (Lond). 2010 Apr;34(4):781-7
pubmed: 20065971
Eur J Cancer Care (Engl). 2018 Mar;27(2):e12611
pubmed: 27921375
Injury. 2006 Dec;37(12):1083-91
pubmed: 17092503
Br J Radiol. 2012 Jan;85(1009):1-10
pubmed: 21937614
Curr Opin Clin Nutr Metab Care. 2008 Sep;11(5):566-72
pubmed: 18685451
Skeletal Radiol. 2018 Jun;47(6):771-777
pubmed: 29247259
Eur Radiol. 2020 Mar;30(3):1701-1708
pubmed: 31776743
Am J Surg. 2020 Dec;220(6):1475-1479
pubmed: 33109335
Trauma Surg Acute Care Open. 2020 Mar 15;5(1):e000414
pubmed: 32201738
Surgery. 2017 Aug;162(2):377-384
pubmed: 28551380
Int J Surg. 2015 Sep;21:51-6
pubmed: 26166742
Obesity (Silver Spring). 2013 May;21(5):997-1003
pubmed: 23784903
Health Policy. 2017 Jul;121(7):823-829
pubmed: 28550937
Eur J Trauma Emerg Surg. 2021 Dec;47(6):1787-1795
pubmed: 32277250
J Diabetes Sci Technol. 2008 Nov;2(6):1139-46
pubmed: 19885303
West J Emerg Med. 2017 Aug;18(5):835-845
pubmed: 28874935
Injury. 2019 Sep;50(9):1565-1576
pubmed: 31280971
Age Ageing. 2019 Jan 1;48(1):16-31
pubmed: 30312372
J Trauma. 1974 Mar;14(3):187-96
pubmed: 4814394
Arch Dis Child. 2006 Jul;91(7):612-7
pubmed: 16790722
BMJ Open. 2016 Jun 08;6(6):e010973
pubmed: 27279477
J Appl Physiol (1985). 2004 Dec;97(6):2333-8
pubmed: 15310748
Injury. 2013 Sep;44(9):1145-52
pubmed: 23219239
Front Nutr. 2022 May 12;9:781860
pubmed: 35634380
Circulation. 2006 Feb 14;113(6):898-918
pubmed: 16380542
J Surg Oncol. 2015 Oct;112(5):503-9
pubmed: 26310812
Cureus. 2019 Nov 14;11(11):e6154
pubmed: 31890363
J Cachexia Sarcopenia Muscle. 2017 Aug;8(4):630-638
pubmed: 28513088
J Pers Med. 2021 Feb 24;11(3):
pubmed: 33668286