Visualizing Frailty: Exploring Radiographical Measures of Frailty in Trauma Patients

Author:

Fakunle Omolola,Patel Meet,Kravets Victoria G.,Singer Adam,Hernandez-Irizarry Robert,Schenker Mara L.ORCID

Abstract

Purpose: This study assessed the relationship of core muscle sarcopenia, myosteatosis, and L1 attenuation to the 5-factor modified frailty index (mFI-5), discharge disposition, and post-admission complications in orthopedic and general trauma patients. It was hypothesized that reduced sarcopenia, L1 attenuation, and increased myosteatosis is associated with higher mFI-5 scores (≥ 0.3), discharge into care, and increased post-admission complications.Methods: This prospective cohort study was performed at a Level 1 trauma center. Patients were surveyed and metrics of the mFI-5 were used. Frail was categorized as a mFI-5 score ≥ 0.3. Recent abdominal computed tomography (CT) scans were used to extract radiographical information of total psoas cross-sectional area, psoas myosteatosis, and L1 vertebrae attenuation.Results: There were 140 patients who consented to the study, of which 83 had available abdomen and pelvis CT scans. The mean age was 43.19 (± 17.36), and 65% were male (<i>n</i> = 52). When comparing the frail (16%, <i>n</i> = 13) and not frail (84%, <i>n</i> = 70) patients, there was a significant difference in mean psoas myosteatosis (<i>p</i> < 0.0001) and the attenuation of the L1 vertebrae (<i>p</i> < 0.001). On multivariate analysis when accounting for age, myosteatosis of the psoas muscles was predictive of an mFI-5 score ≥ 0.3.Conclusion: The findings suggest that myosteatosis and L1 attenuation are associated with frailty indices (mFI-5) after traumatic injury. Future studies are needed to prospectively assess the validity of both radiographical and index-based markers of frailty in predicting post-traumatic complications, mortality, and hospital utilization.

Publisher

Korean Society of Acute Care Surgery

Subject

Electrical and Electronic Engineering,Building and Construction

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