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Sarcopenia and Frailty in Elderly Trauma Patients

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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 cm2 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.

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Acknowledgments

Funding for this project was supported in part by Centers for Disease Control and Prevention Grant R49/CE001175 and in part by the National Institute on Aging Training Grant T35 AG029793-05. Imaging Software was funded through the MCW Research Affairs Committee Grant.

Conflict of interest

There are no real or potential conflicts of interest to disclose.

Author information

Author notes

  1. Karen J. Brasel

    Present address: Oregon Health & Science University, Portland, OR, 97239, USA

  2. Berry Fairchild

    Present address: The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX, 77030, USA

Authors and Affiliations

  1. Medical College of Wisconsin Dept. of Surgery, Division of Trauma and Critical Care, Milwaukee, WI, 53226, USA

    Berry Fairchild, Travis P. Webb, Qun Xiang, Sergey Tarima & Karen J. Brasel

Authors
  1. Berry Fairchild
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  2. Travis P. Webb
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  3. Qun Xiang
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  4. Sergey Tarima
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  5. Karen J. Brasel
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Correspondence to Berry Fairchild.

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Fairchild, B., Webb, T.P., Xiang, Q. et al. Sarcopenia and Frailty in Elderly Trauma Patients. World J Surg 39, 373–379 (2015). https://doi.org/10.1007/s00268-014-2785-7

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  • DOI: https://doi.org/10.1007/s00268-014-2785-7

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