S. E. Hovsepian1, C. H. Zwemer1, S. H. Wu1, C. M. Farag1, A. Herur-Raman1, A. Ismail1, A. P. Srivastava1, O. Melnyk1, S. Kartiko1 1George Washington University School Of Medicine And Health Sciences, Surgery, Washington, DC, USA
Introduction:
Sarcopenia, or the loss of lean muscle mass, is associated with increased morbidity and mortality as well as poor surgical outcomes. Current objective measures of sarcopenia include nutritional assessments of malnutrition, axial skeletal muscle area, and psoas muscle index which is a cross sectional area of the psoas muscle at the L3 or L4 spinal vertebral level via computed tomography (CT) scans. Psoas muscle volume has been used in the literature as another surrogate for sarcopenia and can be used as a diagnostic tool in patients with hip fractures.
Methods:
A retrospective cohort of 64 surgical hip fracture patients presenting at a single institution level 1 ACS verified trauma center who underwent Computed Tomography (CT) of the Abdomen and Pelvis within 1 week of injury from 2017-2022 were considered for analysis. The primary endpoint is to predict patients’ disposition after hospitalization. Total psoas volume (TPV) was collected via 3D reconstruction and analysis of CT scans. A test for normality was conducted to confirm normal distribution of psoas volumes. Student’s t test was used to test for association between TPV and demographic variables. Binary logistic regressions were performed to examine variables that could predict patient disposition amongst the patients who did undergo surgery. TPV values are listed in cm3.
Results:
Sixty-four patients with hip fracture underwent surgical intervention, with 57.8% of the cohort being male. The median age of the cohort is 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 (cm3) amongst the cohort. Surgical patients who were able to be discharged home as opposed to a skilled nursing or other rehab facility also had higher TPV (cm3) (251.3 vs. 191.1, p = 0.02). In multivariable analysis adjusting for sex, race, BMI, and age, patients who had surgery were more likely to be discharged home as their TPV (cm3) increased (OR 1.012, 95% CI 1.004 – 1.020, p = 0.028).
Conclusion:
Psoas muscle volume as a surrogate measure of sarcopenia, can be a readily available tool used to whether a patient will be discharged home from the hospital.