Skeletal muscle predicts ventilator-free days, ICU-free days, and mortality in elderly ICU patients

• DOI: 10.1186/cc12901
• Publication Date: 2013-09-19T11:01:51Z
• Authors: Lesley L Moisey; Marina Mourtzakis; Bryan A Cotton; Tahira Premji; Daren K Heyland; Charles E Wade; Eileen Bulger; Rosemary A Kozar
• Keywords: Underweight; Sarcopenic obesity; Univariate analysis

As the population ages, number of injured elderly is increasing. We sought to determine if low skeletal muscle mass adversely affected outcome in patients following trauma. Patients ≥ 65 years age with an admission abdominal computed tomography scan and requiring intensive care unit (ICU) stay at a Level I trauma center 2009–2010 were reviewed. Muscle cross-sectional area 3rd lumbar vertebra was quantified index, normalized measure mass, calculated related clinical parameters including ventilator-free days, ICU-free mortality. Using previously established sex-specific, index cut-points, then categorized as sarcopenic or non-sarcopenic differences outcomes between these two groups also compared. examined continuous variable relative same outcomes. There 149 severely (median 79 years) enrolled this study which 71% sarcopenic. Of who sarcopenic, 9% underweight, 44% normal weight, 47% overweight/obese per body (BMI) classifications. The overall mortality rate 27% univariate analysis demonstrated higher among those (32% vs. 14%, P = 0.018). After controlling for age, sex, injury severity, multiple logistic regression that increased significantly associated decreased (OR 0.93, 95% CI: 0.875-0.997, 0.025). In addition, multivariate linear showed sarcopenia, but not (P 0.004) days 0.002). Neither BMI, serum albumin nor total adipose tissue on indicative survival, days. Sarcopenia highly prevalent traumatic injuries. Traditional measures nutritional assessment, such BMI albumin, do accurately predict elderly. Sarcopenia, however, represents potential new predictor mortality, discharge disposition, ICU utilization. Measurement muscularity allows early identification at-risk may benefit from aggressive multidisciplinary rehabilitative strategies.