43 Computed Tomography (CT) Measurements of Sarcopenia Predict Length of Stay but not Mortality in Elderly Burn Population
Notice bibliographique
Résumé
Frailty and sarcopenia (loss of skeletal muscle mass) are two factors associated with aging. Previous studies indicate frailty scores are related to mortality, but sarcopenia has not been examined in elderly burn patients. Our goal was to correlate frailty and sarcopenia with mortality and length of stay (LOS) in burn patients. All burn patients≥60 years old admitted between 2008–2017 who had CT scans of the head, chest or abdomen/pelvis within a week of admission were evaluated. Data included: age, sex, burn size (% TBSA), inhalation injury, LOS, and mortality. Frailty scores were evaluated on admission by two independent practitioners using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA CFS). On CT, the masseter muscles, paraspinal muscles at T12, and all skeletal muscles at L3 were analyzed for skeletal muscle mass index (SMI) and Hounsfield units (HU). Values are presented as means ± standard deviation. 143 patients (47 females and 96 males; 21.9% of all patients over 60 years old) underwent head (n=69), chest (n=50) or abdomen/pelvis (n=60) CT scans. Mean age was 70.4±8.7 years with a mean TBSA of 15.0±14.2% and a mean LOS of 25.2±20.6 days. Twenty-seven patients (18.9%) had inhalation injury; 28 (19.5%) died of their injuries while in the hospital. Logistic regression showed that the log odds of mortality significantly increased with TBSA but not age. The mean CSHA CFS was 4.34±1.0 and was not a predictor of mortality (p = 0.15) or LOS (p = 0.452). None of the CT metrics (at the level of the masseter, T12 or L3) were predictors of mortality while in the hospital. At L3 none of the CT metrics were significant predictors of LOS. However, T12 and masseter CT measurements of SMI were predictors of LOS (p<0.05). Patients in the “normal” range for SMI had significantly shorter LOS than those with sarcopenia. None of the HU metrics were significant. Previously, CSHA CFS has been predictive of mortality in an elderly burn population; however in the sub-group of patients who underwent CT scans this was not the case. Measurements of low SMI of the masseter muscle on head CT and of the paraspinal muscles at T12 were predictive of longer LOS. Only a small percentage of elderly burn patients received a CT scan. Further study is needed to determine the ability of frailty and sarcopenia to predict outcomes in an elderly burn population. Sarcopenia and frailty should be considered as predictors of poor outcomes. Use of masseter muscle measurements for sarcopenia is a novel approach that needs to be further studied and additional modalities for measuring sarcopenia beyond CT scan should be examined.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».