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The psoas muscle index as a predictor of mortality and morbidity of geriatric trauma patients: experience of a major trauma center in Kobe

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Abstract

Purpose

An association between the prognoses of trauma and sarcopenia has not been well documented. The purpose of this study was to compare the outcomes of elderly Japanese trauma patients with sarcopenia and those without sarcopenia.

Methods

The medical records of patients aged ≧ 65 years old and Injury Severity Scores above 15 treated for trauma between 2010 and 2017 were reviewed, retrospectively. We measured the psoas muscle index (PMI), defined as the psoas muscle area at the third lumbar vertebra level divided by the body surface area. Patients of each gender with a PMI less than the lower interquartile range were included in the sarcopenia group. A questionnaire was mailed to the patients or their families to collect data on 1-year mortality and activities of daily living.

Results

There were 405 patients included in this study: 304 in the non-sarcopenia group (Group NS) and 101 in the sarcopenia group (Group S). Mortality was significantly higher in Group S than in Group NS (NS; 7.9% vs. S; 15.8%, OR, 2.20; 95% CI, 1.12–4.32; p = 0.027). Only 175 of the questionnaires were completed and the responses did not reveal any significant differences between the groups.

Conclusions

Sarcopenia as defined by the PMI may be used as an indicator for mortality risk for geriatric trauma patients.

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Acknowledgements

This study was partially supported by a grant from the KAKENHI (18K08887).

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Authors and Affiliations

  1. Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, Okayama, 700-8558, Japan

    Takeshi Nishimura, Hiromichi Naito, Noritomo Fujisaki & Atsunori Nakao

  2. Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, chuo-ku, Kobe, Hyogo, 651-0073, Japan

    Takeshi Nishimura, Satoshi Ishihara & Shinichi Nakayama

Authors
  1. Takeshi Nishimura
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  2. Hiromichi Naito
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  3. Noritomo Fujisaki
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  4. Satoshi Ishihara
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  5. Atsunori Nakao
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  6. Shinichi Nakayama
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Contributions

TN, HN, NF, SI, AN, and SN conceived and designed the reports. TN, HN, and NF analyzed and interpreted the data. SI, AN, and SN drafted the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Takeshi Nishimura.

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Nishimura, T., Naito, H., Fujisaki, N. et al. The psoas muscle index as a predictor of mortality and morbidity of geriatric trauma patients: experience of a major trauma center in Kobe. Surg Today 50, 1016–1023 (2020). https://doi.org/10.1007/s00595-020-01980-1

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  • DOI: https://doi.org/10.1007/s00595-020-01980-1

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