Brian M Shear, Anthony K Chiu, Adam Stombler, Sabrina Bustos, Amit Ratanpal, Rohan I Suresh, Alexander Ruditsky, Alexandra Lutz, Mario Sahlani, Jake Carbone, Idris Amin, Jay Karri, Louis J Bivona, Julio J Jauregui, Daniel L Cavanaugh, Eugene Y Koh, Steven C Ludwig
{"title":"肌少症伴虚弱及面积剥夺指数预测胸腰椎外伤术后死亡率及并发症的比较。","authors":"Brian M Shear, Anthony K Chiu, Adam Stombler, Sabrina Bustos, Amit Ratanpal, Rohan I Suresh, Alexander Ruditsky, Alexandra Lutz, Mario Sahlani, Jake Carbone, Idris Amin, Jay Karri, Louis J Bivona, Julio J Jauregui, Daniel L Cavanaugh, Eugene Y Koh, Steven C Ludwig","doi":"10.1097/BSD.0000000000001812","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis.</p><p><strong>Objective: </strong>To compare sarcopenia to frailty and socioeconomic deprivation as preoperative predictors of mortality and complications in thoracolumbar spine trauma.</p><p><strong>Summary of background data: </strong>Sarcopenia is a progressive musculoskeletal disorder characterized by the loss of muscle mass and function. Recently, it has gained recognition as an important surgical risk factor. Prior studies have demonstrated its association with adverse outcomes in spine surgery for degenerative, deformity, and neoplastic indications. Currently, there is a dearth of literature investigating the role of sarcopenia in thoracolumbar trauma.</p><p><strong>Methods: </strong>Adult patients undergoing instrumentation and stabilization of thoracolumbar spine trauma were identified at an urban academic level-1 trauma center. Sarcopenia was measured using the L3 total psoas area over vertebral body area (L3-TPA/VBA) measured from perioperative computed tomography (CT) scans. Area deprivation index (ADI) was determined according to the publicly available Neighborhood Atlas data set. Frailty was measured using the modified 5-factor frailty index (mFI-5). Statistical analysis consisted of Pearson χ 2 tests, univariate logistic regression, determination of Spearman correlation coefficient ( rs ), and multivariable logistic regression controlling for demographics and polytraumatic injuries.</p><p><strong>Results: </strong>A total of 276 patients were included. A total of 22 mortalities occurred (7.7%), with 18 (6.3%) occurring within 90-days postoperatively. On univariate analysis, only the mFI-5 scale was associated with 1-month (OR=2.42, P <0.001), 3-month (OR=2.61, P <0.001), and overall mortality (OR=2.29, P <0.001). On multivariate analysis, none of the sarcopenia, ADI, or mFI-5 were independently associated with mortality, the occurrence of postoperative complications, or revision.</p><p><strong>Conclusions: </strong>Frailty is a better predictor of mortality in thoracolumbar trauma when compared with sarcopenia and ADI. However, an mFI threshold of 2+ may act synergistically with sarcopenia to increase mortality rates.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E54-E62"},"PeriodicalIF":1.9000,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Sarcopenia With Frailty and Area Deprivation Index for Predicting Postoperative Mortality and Complications in Thoracolumbar Trauma.\",\"authors\":\"Brian M Shear, Anthony K Chiu, Adam Stombler, Sabrina Bustos, Amit Ratanpal, Rohan I Suresh, Alexander Ruditsky, Alexandra Lutz, Mario Sahlani, Jake Carbone, Idris Amin, Jay Karri, Louis J Bivona, Julio J Jauregui, Daniel L Cavanaugh, Eugene Y Koh, Steven C Ludwig\",\"doi\":\"10.1097/BSD.0000000000001812\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective analysis.</p><p><strong>Objective: </strong>To compare sarcopenia to frailty and socioeconomic deprivation as preoperative predictors of mortality and complications in thoracolumbar spine trauma.</p><p><strong>Summary of background data: </strong>Sarcopenia is a progressive musculoskeletal disorder characterized by the loss of muscle mass and function. Recently, it has gained recognition as an important surgical risk factor. Prior studies have demonstrated its association with adverse outcomes in spine surgery for degenerative, deformity, and neoplastic indications. Currently, there is a dearth of literature investigating the role of sarcopenia in thoracolumbar trauma.</p><p><strong>Methods: </strong>Adult patients undergoing instrumentation and stabilization of thoracolumbar spine trauma were identified at an urban academic level-1 trauma center. Sarcopenia was measured using the L3 total psoas area over vertebral body area (L3-TPA/VBA) measured from perioperative computed tomography (CT) scans. Area deprivation index (ADI) was determined according to the publicly available Neighborhood Atlas data set. Frailty was measured using the modified 5-factor frailty index (mFI-5). Statistical analysis consisted of Pearson χ 2 tests, univariate logistic regression, determination of Spearman correlation coefficient ( rs ), and multivariable logistic regression controlling for demographics and polytraumatic injuries.</p><p><strong>Results: </strong>A total of 276 patients were included. A total of 22 mortalities occurred (7.7%), with 18 (6.3%) occurring within 90-days postoperatively. On univariate analysis, only the mFI-5 scale was associated with 1-month (OR=2.42, P <0.001), 3-month (OR=2.61, P <0.001), and overall mortality (OR=2.29, P <0.001). On multivariate analysis, none of the sarcopenia, ADI, or mFI-5 were independently associated with mortality, the occurrence of postoperative complications, or revision.</p><p><strong>Conclusions: </strong>Frailty is a better predictor of mortality in thoracolumbar trauma when compared with sarcopenia and ADI. 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Comparison of Sarcopenia With Frailty and Area Deprivation Index for Predicting Postoperative Mortality and Complications in Thoracolumbar Trauma.
Study design: Retrospective analysis.
Objective: To compare sarcopenia to frailty and socioeconomic deprivation as preoperative predictors of mortality and complications in thoracolumbar spine trauma.
Summary of background data: Sarcopenia is a progressive musculoskeletal disorder characterized by the loss of muscle mass and function. Recently, it has gained recognition as an important surgical risk factor. Prior studies have demonstrated its association with adverse outcomes in spine surgery for degenerative, deformity, and neoplastic indications. Currently, there is a dearth of literature investigating the role of sarcopenia in thoracolumbar trauma.
Methods: Adult patients undergoing instrumentation and stabilization of thoracolumbar spine trauma were identified at an urban academic level-1 trauma center. Sarcopenia was measured using the L3 total psoas area over vertebral body area (L3-TPA/VBA) measured from perioperative computed tomography (CT) scans. Area deprivation index (ADI) was determined according to the publicly available Neighborhood Atlas data set. Frailty was measured using the modified 5-factor frailty index (mFI-5). Statistical analysis consisted of Pearson χ 2 tests, univariate logistic regression, determination of Spearman correlation coefficient ( rs ), and multivariable logistic regression controlling for demographics and polytraumatic injuries.
Results: A total of 276 patients were included. A total of 22 mortalities occurred (7.7%), with 18 (6.3%) occurring within 90-days postoperatively. On univariate analysis, only the mFI-5 scale was associated with 1-month (OR=2.42, P <0.001), 3-month (OR=2.61, P <0.001), and overall mortality (OR=2.29, P <0.001). On multivariate analysis, none of the sarcopenia, ADI, or mFI-5 were independently associated with mortality, the occurrence of postoperative complications, or revision.
Conclusions: Frailty is a better predictor of mortality in thoracolumbar trauma when compared with sarcopenia and ADI. However, an mFI threshold of 2+ may act synergistically with sarcopenia to increase mortality rates.
期刊介绍：
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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