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Computed tomography measured psoas density predicts outcomes in trauma.

ABSTRACT: Age-related loss of muscle mass and function (sarcopenia) is linked to poor outcomes after operation and trauma. Here we evaluate computed tomography measured psoas muscle density and area using quick and simple tools available to the bedside clinician. We hypothesize these measures will predict poor outcomes after blunt traumatic injury.We conducted a retrospective cohort study of patients ages ?45 years in the Ohio State University Trauma Registry in 2008 that received a computed tomographic scan of the abdomen and/or pelvis with intravenous contrast. Psoas Index and Hounsfield unit average calculation were measured at the L3 level. In the study, 90-day mortality, complication, duration of stay ?7 days, and dependent discharge were compared with Psoas Index and Hounsfield unit average calculation.In the study, 151 patients met the inclusion criteria. Patients were stratified into interquartile ranges based either on Psoas Index or Hounsfield unit average calculation values. After adjustment with sex-specific cutoffs, the lowest interquartile range of Psoas Index was associated with 90-day mortality (relative risk [RR] 5.95, P < .008), but did not reach significance in other outcomes. The lowest interquartile range of Hounsfield unit average calculation was associated with 90-day mortality (RR 5.95, P < .008), duration of stay ? 7 days (RR 1.63, P = .048), complication risk (RR 2.30, P = .002), and dependent discharge 2.14, P = .015).Psoas muscle density is a significant predictor of poor outcomes after traumatic injury. This objective, quick, and readily available measure of sarcopenia can identify patients requiring aggressive nutritional and physical therapy to improve prognosis, prevent recurrent traumatic injury, and aid in discharge planning.

SUBMITTER: Yoo T

PROVIDER: S-EPMC5893151 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Computed tomography measured psoas density predicts outcomes in trauma.

Yoo Taehwan T Lo Wilson D WD Evans David C DC

Surgery 20170524 2

<h4>Background</h4>Age-related loss of muscle mass and function (sarcopenia) is linked to poor outcomes after operation and trauma. Here we evaluate computed tomography measured psoas muscle density and area using quick and simple tools available to the bedside clinician. We hypothesize these measures will predict poor outcomes after blunt traumatic injury.<h4>Methods</h4>We conducted a retrospective cohort study of patients ages ≥45 years in the Ohio State University Trauma Registry in 2008 tha ...[more]

PMID: 28551380

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Project description:Positron emission tomography (PET) visualizes increased cellular [F]fluorodeoxyglucose ([F]FDG) uptake. Pulmonary hypertension (PH) is conceived of a proliferative disease of the lung vessels. Increased glucose uptake can be quantified as pulmonary [F]FDG uptake via PET imaging. Because the angioproliferative mechanisms in PH are still in need of further description, the aim of the present study was to investigate whether [F]FDG PET/CT imaging can elucidate these pathophysiologic mechanisms in different etiologies of PH.Patients (n?=?109) with end-stage pulmonary disease being evaluated for lung transplant were included in this observational study. Mean standardized uptake value (SUVmean) of predefined regions of interest in lung parenchyma (LP), left (LV), and right ventricle (RV) of the heart, and SUVmax in pulmonary artery (PA) were determined and normalized to liver uptake. These SUV ratios (SUVRs) were compared with results from right heart catheterization (mean pulmonary artery pressure [mPAP], pulmonary vascular resistance [PVR]), and serum N-terminal pro-brain natriuretic peptide. Group comparisons were performed and Pearson correlation coefficients (r) were calculated.The [F]FDG uptake ratios in LP, RV, RV/LV, and PA, but not in LV, were found to be significantly higher in both patients with mPAP ?25?mm Hg (P?=?0.013, P?=?0.006, P?=?0.049, P?=?0.002, P?=?0.68, respectively) and with PVR ?480?dyn·s/cm (P?<?0.001, P?=?0.045, P?<?0.001, P?<?0.001, P?=?0.26, respectively). The [F]FDG uptake in these regions positively correlated also with mPAP, PVR, and N-terminal pro-brain natriuretic peptide. The SUVR of PA positively correlated with the SUVR of LP and RV (r?=?0.55, r?=?0.42, respectively).Pulmonary and cardiac [F]FDG uptake in PET imaging positively correlated with the presence and severity of PH in patients with end-stage pulmonary disease. Increased glucose metabolism in the central PAs seems to play a certain role in terms of severity of PH. These results suggest that [F]FDG-PET imaging can help understand the pathophysiology of PH as a proliferative pulmonary disease.

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Computed tomography measured psoas density predicts outcomes in trauma.

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Computed tomography measured psoas density predicts outcomes in trauma.

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