Journal of Trauma and Acute Care Surgery, Publish Ahead of Print DOI: 10.1097/TA.0000000000000989
CT abbreviated assessment of sarcopenia following trauma: The CAAST measurement predicts 6-month mortality in older adult trauma patients
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Christine Leeper, MD, Elizabeth Lin, BS, Marcus Hoffman, MD, Anisleidy Fombona, BA, Tianhua Zhou, BA, Matthew Kutcher, MD, Matthew Rosengart, MD, MPH Gregory Watson,
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MD, Timothy Billiar, MD, Andrew Peitzman, MD, Brian Zuckerbraun, MD, Jason Sperry, MD MPH
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From the University of Pittsburgh Medical Center (C.L., M.H., M.K., M.R., G.W., T.B., A.P., B.Z., J.S.), Pittsburgh, Pennsylvania; and the University of Pittsburgh School of Medicine (E.L., A.F., T.Z., ), Pittsburgh, Pennsylvania.
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Submitted: August 28, 2015, Revised: December 17, 2015, Accepted: December 30, 2015.
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*There are no disclosures to report*
A
Christine Leeper, MD
General Surgery Resident Postdoctoral Research Fellow University of Pittsburgh Medical Center 200 Lothrop Street Pittsburgh, Pennsylvania 15213 1
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Email: [email protected]
Elizabeth Lin BS University of Pittsburgh School of Medicine M240 Scaife Hall
D
3550 Terrace St, Pittsburgh, PA 15261
Marcus Hoffman MD Trauma & Acute Care Surgery Fellow
200 Lothrop Street
EP
University of Pittsburgh Medical Center
TE
[email protected]
Pittsburgh, Pennsylvania 15213
C
[email protected]
C
Anisleidy Fombona BA
University of Pittsburgh School of Medicine
A
M240 Scaife Hall
3550 Terrace St, Pittsburgh, PA 15261 [email protected]
Tianhua Zhou BA University of Pittsburgh School of Medicine
2
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
M240 Scaife Hall 3550 Terrace St, Pittsburgh, PA 15261 [email protected]
Matthew Kutcher, MD
D
Surgical Critical Care Fellow
200 Lothrop Street Pittsburgh, Pennsylvania 15213
EP
[email protected]
TE
University of Pittsburgh Medical Center
Matthew Rosengart, MD MPH
Associate Professor, Surgery and Critical Care Medicine University of Pittsburgh Medical Center
C
200 Lothrop Street
C
Pittsburgh, Pennsylvania 15213
A
[email protected]
Gregory Watson, MD Assistant Professor, Surgery and Critical Care Medicine University of Pittsburgh Medical Center 200 Lothrop Street Pittsburgh, Pennsylvania 15213
3
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
[email protected]
Timothy Billiar, MD Chair, Department of Surgery George Vance Foster Endowed Professor
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Distinguished Professor of Surgery
200 Lothrop Street Pittsburgh, Pennsylvania 15213
EP
[email protected]
TE
University of Pittsburgh Medical Center
Andrew Peitzman, MD
Distinguished Professor of Surgery
Mark M. Ravitch Professor and Vice-Chairman, Department of Surgery
C
UPMC Vice-President for Trauma and Surgical Services
C
University of Pittsburgh School of Medicine F-1281, UPMC-Presbyterian
A
Pittsburgh, Pa 15213
[email protected]
Brian Zuckerbraun, MD Associate Professor, Surgery and Critical Care Medicine University of Pittsburgh Medical Center
4
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
200 Lothrop Street Pittsburgh, Pennsylvania 15213 [email protected]
*Corresponding Author Associate Professor, Surgery and Critical Care Medicine
Suite F1268 PUH University of Pittsburgh Medical Center
EP
200 Lothrop Street
TE
Associate Director of Acute Care Surgery Fellowship
D
Jason Sperry, MD MPH
Pittsburgh, Pennsylvania 15213 Office: 412-802-8270 Fax: 412-648-6872
C
[email protected]
C
This study was presented as a quick shot presentation at the 74th annual meeting of the American
A
Association for the Surgery of Trauma, September 9–12, 2015, in Las Vegas, Nevada.
5
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Abstract Background: Older adult trauma patients are at increased risk of poor outcome, both immediately after injury and beyond hospital discharge. Identifying patients early in the hospital stay who are at increased risk of death after discharge can be challenging.
D
Methods:
Retrospective analysis was performed using our trauma registry linked with the social security
TE
death index from 2010-2014. Age was categorized by 18-64 and ≥65 years. We calculated mortality rates by age category then selected elderly patients with mechanism of injury being a fall for further analysis. CT Abbreviated Assessment of Sarcopenia for Trauma (CAAST) was
EP
obtained by measuring psoas muscle cross-sectional area adjusted for height and weight. KaplanMeier survival analysis was performed and proportional hazards regression modeling was utilized to determine independent risk factors for in-hospital and out-of-hospital mortality. Results:
C
23,622 patients were analyzed (age 18-64: 16,748 and age≥65: 6,874). In-hospital mortality was 1.96% for age 18-64 and 7.19% for age ≥65 (p
CT abbreviated assessment of sarcopenia following trauma: The CAAST measurement predicts 6-month mortality in older adult trauma patients
D
Christine Leeper, MD, Elizabeth Lin, BS, Marcus Hoffman, MD, Anisleidy Fombona, BA, Tianhua Zhou, BA, Matthew Kutcher, MD, Matthew Rosengart, MD, MPH Gregory Watson,
TE
MD, Timothy Billiar, MD, Andrew Peitzman, MD, Brian Zuckerbraun, MD, Jason Sperry, MD MPH
EP
From the University of Pittsburgh Medical Center (C.L., M.H., M.K., M.R., G.W., T.B., A.P., B.Z., J.S.), Pittsburgh, Pennsylvania; and the University of Pittsburgh School of Medicine (E.L., A.F., T.Z., ), Pittsburgh, Pennsylvania.
C
Submitted: August 28, 2015, Revised: December 17, 2015, Accepted: December 30, 2015.
C
*There are no disclosures to report*
A
Christine Leeper, MD
General Surgery Resident Postdoctoral Research Fellow University of Pittsburgh Medical Center 200 Lothrop Street Pittsburgh, Pennsylvania 15213 1
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Email: [email protected]
Elizabeth Lin BS University of Pittsburgh School of Medicine M240 Scaife Hall
D
3550 Terrace St, Pittsburgh, PA 15261
Marcus Hoffman MD Trauma & Acute Care Surgery Fellow
200 Lothrop Street
EP
University of Pittsburgh Medical Center
TE
[email protected]
Pittsburgh, Pennsylvania 15213
C
[email protected]
C
Anisleidy Fombona BA
University of Pittsburgh School of Medicine
A
M240 Scaife Hall
3550 Terrace St, Pittsburgh, PA 15261 [email protected]
Tianhua Zhou BA University of Pittsburgh School of Medicine
2
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
M240 Scaife Hall 3550 Terrace St, Pittsburgh, PA 15261 [email protected]
Matthew Kutcher, MD
D
Surgical Critical Care Fellow
200 Lothrop Street Pittsburgh, Pennsylvania 15213
EP
[email protected]
TE
University of Pittsburgh Medical Center
Matthew Rosengart, MD MPH
Associate Professor, Surgery and Critical Care Medicine University of Pittsburgh Medical Center
C
200 Lothrop Street
C
Pittsburgh, Pennsylvania 15213
A
[email protected]
Gregory Watson, MD Assistant Professor, Surgery and Critical Care Medicine University of Pittsburgh Medical Center 200 Lothrop Street Pittsburgh, Pennsylvania 15213
3
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
[email protected]
Timothy Billiar, MD Chair, Department of Surgery George Vance Foster Endowed Professor
D
Distinguished Professor of Surgery
200 Lothrop Street Pittsburgh, Pennsylvania 15213
EP
[email protected]
TE
University of Pittsburgh Medical Center
Andrew Peitzman, MD
Distinguished Professor of Surgery
Mark M. Ravitch Professor and Vice-Chairman, Department of Surgery
C
UPMC Vice-President for Trauma and Surgical Services
C
University of Pittsburgh School of Medicine F-1281, UPMC-Presbyterian
A
Pittsburgh, Pa 15213
[email protected]
Brian Zuckerbraun, MD Associate Professor, Surgery and Critical Care Medicine University of Pittsburgh Medical Center
4
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
200 Lothrop Street Pittsburgh, Pennsylvania 15213 [email protected]
*Corresponding Author Associate Professor, Surgery and Critical Care Medicine
Suite F1268 PUH University of Pittsburgh Medical Center
EP
200 Lothrop Street
TE
Associate Director of Acute Care Surgery Fellowship
D
Jason Sperry, MD MPH
Pittsburgh, Pennsylvania 15213 Office: 412-802-8270 Fax: 412-648-6872
C
[email protected]
C
This study was presented as a quick shot presentation at the 74th annual meeting of the American
A
Association for the Surgery of Trauma, September 9–12, 2015, in Las Vegas, Nevada.
5
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Abstract Background: Older adult trauma patients are at increased risk of poor outcome, both immediately after injury and beyond hospital discharge. Identifying patients early in the hospital stay who are at increased risk of death after discharge can be challenging.
D
Methods:
Retrospective analysis was performed using our trauma registry linked with the social security
TE
death index from 2010-2014. Age was categorized by 18-64 and ≥65 years. We calculated mortality rates by age category then selected elderly patients with mechanism of injury being a fall for further analysis. CT Abbreviated Assessment of Sarcopenia for Trauma (CAAST) was
EP
obtained by measuring psoas muscle cross-sectional area adjusted for height and weight. KaplanMeier survival analysis was performed and proportional hazards regression modeling was utilized to determine independent risk factors for in-hospital and out-of-hospital mortality. Results:
C
23,622 patients were analyzed (age 18-64: 16,748 and age≥65: 6,874). In-hospital mortality was 1.96% for age 18-64 and 7.19% for age ≥65 (p
