Hovsepian Sahak E, Zwemer Catherine H, Halpern Alex I, Wu Sophia H, Farag Christian M, Herur-Raman Aalap, Ismail Ahmed, Srivastava Aneil P, Melnyk Oleksiy, Baginsky Mary, Kartiko Susan
Department of Surgery, The George Washington University School of Medicine Health Sciences, Washington, District of Columbia.
George Washington University Hospital, Washington, District of Columbia.
J Surg Res. 2024 Dec;304:67-73. doi: 10.1016/j.jss.2024.10.005. Epub 2024 Nov 9.
Sarcopenia, or the loss of lean muscle mass, is associated with increased morbidity and mortality as well as poor surgical outcomes. The aim of our study was to utilize computed tomography imaging to obtain the total psoas volume (TPV) as a potential marker of sarcopenia. We then investigated the relationship between TPV and outcomes in surgically managed hip fracture patients, particularly their discharge disposition.
A retrospective review of surgically managed hip fracture patients at a single institution level one American College of Surgeons verified trauma center between 2017 and 2022 was performed. The primary endpoint was patient disposition after hospitalization. TPV was collected via three dimension reconstruction of computed tomography images. Student's t-test was used to assess for association between TPV and demographic variables. Binary logistic regressions were performed to examine variables that could predict patient disposition among the patients.
We identified 64 surgically managed hip fracture patients, 57.8% of whom were males, with a median age of 74 (IQR: 62, 88). Black race (244.4 vs. 190.3, P = 0.032) and younger age (252.2 vs. 181.8, P = 0.004) were associated with higher TPV. Male patients with higher TPV had a higher likelihood of being discharged home as opposed to a skilled nursing or rehabilitation facility (251.3 vs. 191.1, P = 0.02). In multivariable analysis adjusting for sex, race, body mass index, and age, males with a higher TPV were more likely to be discharged home (odds ratio: 1.012; 95% confidence interval: 1.004 1.020; P = 0.028).
Psoas muscle volume can be used to predict which male patients are likely to be discharged home postoperatively after surgically managed traumatic hip fracture.
肌肉减少症，即瘦肌肉量的丧失，与发病率和死亡率增加以及手术效果不佳有关。我们研究的目的是利用计算机断层扫描成像来获取腰大肌总体积（TPV），将其作为肌肉减少症的一个潜在标志物。然后，我们调查了TPV与接受手术治疗的髋部骨折患者的预后之间的关系，特别是他们的出院去向。
对2017年至2022年期间在一家由美国外科医师学会一级认证的创伤中心进行手术治疗的髋部骨折患者进行回顾性研究。主要终点是患者出院后的去向。通过计算机断层扫描图像的三维重建收集TPV。采用学生t检验评估TPV与人口统计学变量之间的关联。进行二元逻辑回归分析，以检验可预测患者出院去向的变量。
我们确定了64例接受手术治疗的髋部骨折患者，其中57.8%为男性，中位年龄为74岁（四分位间距：62，88）。黑人种族（244.4对190.3，P = 0.032）和较年轻的年龄（252.2对181.8，P = 0.004）与较高的TPV相关。TPV较高的男性患者出院回家的可能性高于入住专业护理或康复机构的可能性（251.3对191.1，P = 0.02）。在对性别、种族、体重指数和年龄进行调整的多变量分析中，TPV较高的男性更有可能出院回家（比值比：1.012；95%置信区间：1.004至1.020；P = 0.028）。
腰大肌体积可用于预测哪些男性患者在接受手术治疗的创伤性髋部骨折术后可能出院回家。
