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Radiologic Markers of Frailty in an Older Trauma Patients and 1 Year Mortality in the Report of Kaplan et al

Description

Kaplan et al correlated radiologic markers of frailty in an older trauma patient with 1 year mortality rates. These can help to identify patients who may benefit from more aggressive management. The authors are from the University of Washington in Seattle and Harborview Medical Center.


Patient selection: age >= 65 years of age with significant trauma

 

Outcome: 1-year all-cause mortality

 

Measures of frailty (which may be measured in imaging studies performed for other reasons):

(1) sarcopenia (based on total cross-sectional muscle area at L3 vertebral level in square cm adjusted for height in meters squared)

(2) osteopenia (L3 vertebral body less than 100 Hounsfield units, based on a 1.5 to 2 square cm region avoiding sclerotic bone, fracture line, etc)

 

Gender

Skeletal Muscle Index for Sarcopenia

male

< 52.4 cm sq per sq m

female

< 38.5 cm sq per sq m

 

 

Sarcopenia

Osteopenia

1-Year Kaplan Meier Survival

Hazard Ratio 1 Year Mortality

absent

absent

99%

1

absent

present

91%

11.9

present

absent

88%

10.3

present

present

84%

9.4

 

Other factors impacting survival:

(1) higher comorbidity (using a modified Charlson Comorbidity Index)

(2) any in-hospital complication


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