CT-based sarcopenia assessment: Predicting outcomes in acute infection patients.

IF 2.5 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of Investigative Medicine Pub Date : 2025-01-01 Epub Date: 2024-10-24 DOI:10.1177/10815589241280861
Matan Elkan, Lior Cochavi, Alla Khashper, Eli Kravchik, Ella Kravitz, Ronit Koren
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Abstract

In this retrospective cohort study, we investigated the prognostic value of sarcopenia evaluated by Computed Tomography (CT)-based indices for adverse hospitalization outcomes in patients with acute infections. We analyzed data from 225 patients admitted to the hospital for acute infections between 2019 and 2020. Patients who had undergone an abdominal CT scan either up to 1 month before or within the first 3 days of hospitalization were included. CT image analysis was used to evaluate skeletal muscle mass (by skeletal muscle index (SMI)) and muscle quality (by psoas muscle density, pMD). Low pMD was associated with higher in-hospital mortality (31% vs 11.4% p < 0.001) as well as higher longer-term mortality rates (p = 0.008 for 30 days and <0.001 for 90- and 1-year mortality). Low pMD remained an independent poor prognostic factor after controlling for confounders, with an adjusted odds ratio (aOR) of 2.74, (95% CI 1.33-5.67, p = 0.006) for 1-year mortality, and aOR of 2.61, (95% CI 1.23-5.55) for a prolonged hospital stay. Low SMI was associated with adverse outcomes, although this association was not independent after controlling for confounders. Notably, patients with both low SMI and pMD exhibited the poorest hospitalization outcomes: aOR for 1-year mortality 5.015 (95% CI 1.767-14.23, p = 0.002), and prolonged length of stay aOR 3.197, (95% CI 1.159-8.821, p = 0.025). CT-based muscle indices serve as independent prognostic factors in medical patients admitted with acute infection. Incorporating radiological assessments of sarcopenia into routine care for hospitalized patients with acute infection may enable risk stratification and early intervention in reversible conditions.

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快讯基于 CT 的肌肉疏松症评估:预测急性感染患者的预后。
研究目的在这项回顾性队列研究中,我们调查了通过基于CT的指标评估的肌肉疏松症对急性感染患者不良住院结局的预后价值:我们分析了 2019 年至 2020 年期间因急性感染入院的 225 名患者的数据。纳入的患者均在住院前一个月或住院后 3 天内接受过腹部 CT 扫描。计算机断层扫描图像分析用于评估骨骼肌质量(通过骨骼肌指数- SMI)和肌肉质量(通过腰肌密度- pMD):结果:低 pMD 与较高的院内死亡率相关(31% 对 11.4%):基于 CT 的肌肉指数是急性感染住院病人的独立预后因素。将肌肉疏松症的放射学评估纳入急性感染住院病人的常规护理中,可实现风险分层并对可逆情况进行早期干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Investigative Medicine
Journal of Investigative Medicine 医学-医学:内科
CiteScore
4.90
自引率
0.00%
发文量
111
审稿时长
24 months
期刊介绍: Journal of Investigative Medicine (JIM) is the official publication of the American Federation for Medical Research. The journal is peer-reviewed and publishes high-quality original articles and reviews in the areas of basic, clinical, and translational medical research. JIM publishes on all topics and specialty areas that are critical to the conduct of the entire spectrum of biomedical research: from the translation of clinical observations at the bedside, to basic and animal research to clinical research and the implementation of innovative medical care.
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