Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Eur Radiol Exp. 2021 Feb 16;5(1):9. doi: 10.1186/s41747-021-00206-4.
Rib fractures are associated with considerable morbidity and mortality. Surgical stabilization of rib fractures (SSRF) can be performed to mitigate complications. Sarcopenia is in general known to be associated with poor clinical outcomes. We investigated if sarcopenia impacted number of days of mechanical ventilation, intensive care unit (ICU) stay, and total hospital stay in patients who underwent SSRF.
A retrospective single institutional review was performed including patients who underwent SSRF (2009-2017). Skeletal muscle index (SMI) was semiautomatically calculated at the L3 spinal level on computed tomography (CT) images and normalized by patient height. Sarcopenia was defined as SMI < 55 cm/m in males and < 39 cm/m in females. Demographics, operative details, and postoperative outcomes were reviewed. Univariate and multivariate analyses were performed.
Of 238 patients, 88 (36.9%) had sarcopenia. There was no significant difference in number of days of mechanical ventilation (2.8 ± 4.9 versus 3.1 ± 4.3, p = 0.304), ICU stay (5.9 ± 6.5 versus 4.9 ± 5.7 days, p = 0.146), or total hospital stay (13.3 ± 7.2 versus 12.9 ± 8.2 days, p = 0.183) between sarcopenic and nonsarcopenic patients. Sarcopenic patients demonstrated increased modified frailty index scores (1.5 ± 1.1 versus 0.9 ± 0.9, p < 0.001) compared to nonsarcopenic patients.
For patients who underwent SSRF for rib fractures, sarcopenia did not increase the number of days of mechanical ventilation, ICU stay, or total hospital stay. Sarcopenia should not preclude the utilization of SSRF in these patients.
肋骨骨折与相当大的发病率和死亡率有关。外科固定肋骨骨折（SSRF）可减轻并发症。一般来说，肌肉减少症与不良临床结局相关。我们研究了 SSRF 患者的肌肉减少症是否影响机械通气天数、重症监护病房（ICU）住院时间和总住院时间。
对 2009 年至 2017 年进行 SSRF 的患者进行回顾性单机构研究。在 CT 图像上 L3 脊柱水平半自动计算骨骼肌指数（SMI），并通过患者身高进行标准化。男性 SMI<55cm/m 和女性 SMI<39cm/m 定义为肌肉减少症。回顾了人口统计学、手术细节和术后结果。进行了单变量和多变量分析。
在 238 名患者中，88 名（36.9%）有肌肉减少症。机械通气天数（2.8±4.9 与 3.1±4.3，p=0.304）、ICU 住院时间（5.9±6.5 与 4.9±5.7 天，p=0.146）或总住院时间（13.3±7.2 与 12.9±8.2 天，p=0.183）在肌肉减少症患者和非肌肉减少症患者之间无显著差异。与非肌肉减少症患者相比，肌肉减少症患者的改良虚弱指数评分更高（1.5±1.1 与 0.9±0.9，p<0.001）。
对于因肋骨骨折而行 SSRF 的患者，肌肉减少症不会增加机械通气天数、ICU 住院时间或总住院时间。在这些患者中，肌肉减少症不应排除 SSRF 的使用。
