TY - JOUR
T1 - Image-based assessment of sarcopenic obesity predicts mortality in major trauma
AU - Oh, John S.
AU - Ssentongo, Anna E.
AU - Ssentongo, Paddy
AU - Dykes, Thomas
AU - Keeney, Laura
AU - Armen, Scott B.
AU - Soybel, David I.
N1 - Funding Information:
The authors would like to thank Ms. Julia Crum for her invaluable expertise with the trauma registry and data abstraction, and Ms. Barbara Baker for her expertise in manuscript formatting and preparation.
Publisher Copyright:
© 2021
PY - 2021
Y1 - 2021
N2 - Background: Patients with obesity are also at risk for sarcopenia, which is difficult to recognize in this population. Our study examines whether sarcopenic-obesity (SO) is independently associated with mortality in trauma. Methods: Using a retrospective database, we performed logistic regression analysis. Admission CT scans were used to identify SO by calculating the visceral fat to skeletal muscle ratio >3.2. Results: Of 883 patients, the prevalence of SO was 38% (333). Patients with SO were more likely to be male (79% versus 43%, p < 0.001), older (mean 66.5 years versus 46.3 years, p < 0.001), and less likely to have an injury severity score (ISS) ≥ 24 (43% versus 55%, p = 0.0003). Using multivariable logistic regression analysis, SO was independently associated with mortality (OR 2.8; 95% CI 1.6–4.8, p < 0.001). Causal mediation analysis found admission hyperglycemia as a mediator for mortality. Conclusions: Sarcopenic obesity is an independent predictor of mortality in major trauma.
AB - Background: Patients with obesity are also at risk for sarcopenia, which is difficult to recognize in this population. Our study examines whether sarcopenic-obesity (SO) is independently associated with mortality in trauma. Methods: Using a retrospective database, we performed logistic regression analysis. Admission CT scans were used to identify SO by calculating the visceral fat to skeletal muscle ratio >3.2. Results: Of 883 patients, the prevalence of SO was 38% (333). Patients with SO were more likely to be male (79% versus 43%, p < 0.001), older (mean 66.5 years versus 46.3 years, p < 0.001), and less likely to have an injury severity score (ISS) ≥ 24 (43% versus 55%, p = 0.0003). Using multivariable logistic regression analysis, SO was independently associated with mortality (OR 2.8; 95% CI 1.6–4.8, p < 0.001). Causal mediation analysis found admission hyperglycemia as a mediator for mortality. Conclusions: Sarcopenic obesity is an independent predictor of mortality in major trauma.
UR - http://www.scopus.com/inward/record.url?scp=85108555071&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85108555071&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2021.06.007
DO - 10.1016/j.amjsurg.2021.06.007
M3 - Article
C2 - 34172258
AN - SCOPUS:85108555071
SN - 0002-9610
VL - 223
SP - 792
EP - 797
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 4
ER -