在中度至重度受伤的老年人中，腰大肌面积与临床结果无关。

Lean psoas area does not correlate with clinical outcomes in moderately to severely injured older people.

作者信息

Couch Andrew P, Ho Kelvin, Darwood Rosie, Hsu Jeremy M

机构信息

Westmead Hospital, Sydney, New South Wales, Australia.

Leeds Teaching Hospitals NHS Trust, Leeds, UK.

出版信息

Australas J Ageing. 2018 Mar;37(1):E7-E11. doi: 10.1111/ajag.12482. Epub 2017 Nov 23.

DOI:10.1111/ajag.12482

PMID:29168295

Abstract

OBJECTIVE

Frailty has been associated with worse outcomes in older trauma patients. Specifically, the utility of lean cross-sectional psoas muscle area (LPA) was examined as a potentially simple objective measure of frailty.

METHODS

Five hundred and fifty-four patients over the age of 65 were admitted with trauma between 2011 and 2014. Two hundred and twenty-five of these had adequate computed tomography imaging available for analysis. Cross-sectional area of the psoas muscle at the inferior endplate of L4 was quantified.

RESULTS

Multivariate regression analysis showed no significant correlation between LPA and outcomes of mortality (P = 0.82) or inpatient complications (P = 0.22). Injury Severity Score (ISS) had a strong association with both mortality (odds ratio (OR) 9.5; 95% confidence interval (CI) 2.9-30.9) and inpatient complications (OR 9.9; 95% CI 3.5-27.7). Age also had an association with mortality (OR 1.09; 95% CI 1.03-1.16) and inpatient complications (OR 1.06; 95% CI 1.01-1.12).

CONCLUSION

Lean psoas area was not an independent predictor of mortality or complications in a cohort of injured older patients.

摘要

目的

衰弱与老年创伤患者更差的预后相关。具体而言，研究了瘦腰大肌横截面积（LPA）作为一种潜在简单的衰弱客观指标的效用。

方法

2011年至2014年间，554名65岁以上的创伤患者入院。其中225名患者有可用的计算机断层扫描成像用于分析。对L4椎体下终板处的腰大肌横截面积进行量化。

结果

多因素回归分析显示，LPA与死亡率（P = 0.82）或住院并发症（P = 0.22）的预后之间无显著相关性。损伤严重程度评分（ISS）与死亡率（比值比（OR）9.5；95%置信区间（CI）2.9 - 30.9）和住院并发症（OR 9.9；95% CI 3.5 - 27.7）均密切相关。年龄也与死亡率（OR 1.09；95% CI 1.03 - 1.16）和住院并发症（OR 1.06；95% CI 1.01 - 1.12）相关。