Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
BMC Geriatr. 2024 Nov 19;24(1):962. doi: 10.1186/s12877-024-05559-0.
To investigate the predictive value of computed tomography (CT)-based transverse diameter (TD) and longitudinal diameter (LD) of the psoas muscle at the level of third lumbar vertebra for 28-day mortality in older patients with sepsis.
This retrospective single-center cohort study included 115 septic patients aged over 65 years old who were admitted to ICU in Beijing-Chaoyang Hospital between July 2017 and July 2022. The TD and LD of psoas muscle were obtained by measurement on abdominal CT images. Logistic regression analysis was conducted to identify the prognostic factors for 28-day mortality in older patients with sepsis, and their predictive performances were evaluated using the receiver operating characteristic (ROC) curve.
Multivariable logistic analysis indicated that TD (OR: 0.405, 95% CI: 0.190-0.864) was a protective factor for 28-day mortality in older patients with sepsis, whereas LD was not. The areas under the curve (AUCs) of TD, APACHE II, and SOFA were 0.666 (95% CI: 0.565-0.767), 0.660 (95% CI: 0.561-0.760), and 0.679 (95% CI: 0.581-0.777), respectively. Furthermore, the AUCs for the combination of TD with APACHE II or SOFA were 0.766 (95% CI: 0.679-0.853, P < 0.001) and 0.765 (95% CI: 0.679-0.852, P < 0.001).
TD of psoas muscle was a predictor for 28-day mortality in older patients with sepsis. The combination of TD with APACHE II or SOFA scores enhances the early identification of patients at high risk for poor prognosis.
not applicable.
探讨 CT 测量第三腰椎水平腰大肌横径（TD）和长径（LD）对老年脓毒症患者 28 天死亡率的预测价值。
本回顾性单中心队列研究纳入了 2017 年 7 月至 2022 年 7 月期间在北京朝阳医院 ICU 收治的 115 例年龄大于 65 岁的脓毒症患者。通过腹部 CT 图像测量腰大肌的 TD 和 LD。采用 logistic 回归分析确定老年脓毒症患者 28 天死亡率的预后因素，并通过受试者工作特征（ROC）曲线评估其预测性能。
多变量 logistic 分析表明，TD（OR：0.405，95%CI：0.190-0.864）是老年脓毒症患者 28 天死亡率的保护因素，而 LD 不是。TD、APACHE II 和 SOFA 的曲线下面积（AUCs）分别为 0.666（95%CI：0.565-0.767）、0.660（95%CI：0.561-0.760）和 0.679（95%CI：0.581-0.777）。此外，TD 与 APACHE II 或 SOFA 联合的 AUC 分别为 0.766（95%CI：0.679-0.853，P<0.001）和 0.765（95%CI：0.679-0.852，P<0.001）。
TD 是老年脓毒症患者 28 天死亡率的预测指标。TD 与 APACHE II 或 SOFA 评分的联合应用可提高对预后不良高风险患者的早期识别。
不适用。
