Psoas cross-sectional area as a predictor of mortality and a diagnostic tool for sarcopenia in hip fracture patients

Byun, Seong‐Eun; Kim, Sujin; Kim, Kyu-Hwang; Ha, Yong‐Chan

doi:10.1007/s00774-019-00986-1

Cited by 30 publications

(32 citation statements)

References 29 publications

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“…In contrast, the intervertebral disc space level is narrower/thinner and enable a more consistent level determination for measurement of the psoas. Several studies have reported measurements at L3–L4 and L4–L5 . The feasibility of measuring tPMA at these two levels has been previously demonstrated in studies assessing paravertebral muscle area with other muscle groups and overall strength in adolescents and adults …”

Section: Discussionmentioning

confidence: 95%

“…In adults and adolescents, CT‐based tPMA values at multiple levels have been published . We elected to evaluate the psoas muscle at two intervertebral disc levels, L3–4 and L4–5 . Although a recent systematic review highlighted L3 to be a commonly reported level in adult patients to assess muscle mass on CT, anatomical variations may complicate reliable identification of borders of the muscle which often requires multiplanar reformation and can be time‐consuming .…”

Section: Discussionmentioning

confidence: 99%

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Paediatric reference values for total psoas muscle area

Lurz

Patel

Lebovic

et al. 2020

J cachexia sarcopenia muscle

146

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Background Sarcopenia, the unintentional loss of skeletal muscle mass, is associated with poor outcomes in adult patient populations. In adults, sarcopenia is often ascertained by cross-sectional imaging of the psoas muscle area (PMA). Although children with chronic medical illnesses may be at increased risk for muscle loss because of nutritional deficiencies, physical deconditioning, endocrine anomalies, and systemic inflammation, consistent quantitative definitions for sarcopenia in children are lacking. We aimed to generate paediatric reference values for PMA at two intervertebral lumbar levels, L3-4 and L4-5. Methods In this cross-sectional study, we analysed abdominal computed tomography scans of consecutive children presenting to the emergency department. Participants were children 1-16 years who required abdominal cross-sectional imaging after paediatric trauma between January 1, 2005 and December 31, 2015 in a large Canadian quaternary care centre. Children with a documented chronic medical illness or an acute spinal trauma at presentation were excluded. Total PMA (tPMA) at levels L3-4 and L4-5 were measured in square millimetres (mm 2 ) as the sum of left and right PMA. Age-specific and sex-specific tPMA percentile curves were modelled using quantile regression. Results Computed tomography images from 779 children were included. Values of tPMA at L4-5 were significantly larger than at L3-4 at all ages, but their correlation was high for both girls (r = 0.95) and boys (r = 0.98). Amongst girls, tPMA 50th percentile values ranged from 365 to 2336 mm 2 at L3-4 and from 447 to 2704 mm 2 for L4-5. Amongst boys, 50th percentile values for tPMA ranged between 394 and 3050 mm 2 at L3-4 and from 498 to 3513 mm 2 at L4-5. Intraclass correlation coefficients were excellent at L3-4 (0.97, 95% CI 0.94 to 0.981) and L4-5 (0.99, 95% CI 0.986 to 0.995). Weight and tPMA were correlated, stratified by sex for boys (L3-4 r = 0.90; L4-5 r = 0.90) and for girls (L3-4 r = 0.87; L4-5 r = 0.87). An online application was subsequently developed to easily calculate age-specific and sex-specific z-scores and percentiles. Conclusions We provide novel paediatric age-specific and sex-specific growth curves for tPMA at intervertebral L3-4 and L4-5 levels for children between the ages of 1-16 years. Together with an online tool (https://ahrc-apps.shinyapps.io/sarcopenia/ ), these tPMA curves should serve as a reference enabling earlier identification and targeted intervention of sarcopenia in children with chronic medical conditions.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Paediatric reference values for total psoas muscle area

Lurz

Patel

Lebovic

et al. 2020

J cachexia sarcopenia muscle

146

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“…Interestingly, one study found no correlation between the initial BCA parameters measured from the CT obtained at the time of the hospital admission and mortality but those who experienced a loss of muscle and fat tissue during the hospital stay had increased mortality [108]. The loss of skeletal muscle mass was reported to predict increased mortality and length of hospital stay in trauma patients [109] and in patients with acetabular [110], [111] and femoral [112], [113], [114] fractures. There are several publications highlighting that sarcopenia appears to be independently associated with increased mortality after emergency laparotomy [115], [116], [117], [118] and cardiac operations [119], [120], [121] and a longer duration of hospital stay after cardiac operations [122].…”

Section: The Ct-determined Loss Of Skeletal Muscle Mass In Clinical Contextmentioning

confidence: 99%

Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review

Tolonen

Pakarinen

Sassi

et al. 2021

European Journal of Radiology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Currently, the value of preoperative paraspinal muscle morphometry on image examination is being unearthed, which has been assessed as a prognostic factor for several surgical disciplines [8][9][10]. Paraspinal muscle morphometry can be visibly characterized by a decreased cross-sectional area (muscle atrophy) and an increase in fat content (fat infiltration).…”

Section: Introductionmentioning

confidence: 99%

The predictive value of preoperative paraspinal muscle morphometry on complications after lumbar surgery: a systematic review

et al. 2021

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Purpose The effect of paraspinal muscles atrophy and fat infiltration (FI) on the complications of spinal surgery has not been established. Methods A review of the literature was conducted from a search of the PubMed, EMBASE, and Web of Science databases from inception through January 2021. The literature was searched and assessed by independent reviewers based on criteria that included an assessment of preoperative paraspinal muscle morphology in addition to measuring its relationship to surgical complications. All relevant papers were assessed for risk of bias according to the modified Newcastle Ottawa Scale and the Joanna Briggs Institute Critical Appraisal Tools. A narrative synthesis was conducted. Results The initial search yielded 5632 studies, of which 16 studies were included in the analysis. All included studies were at a low risk of bias. There existed strong evidence that the atrophy and FI of paraspinal muscles had an association with the development of bone nonunion (two high quality studies), pedicle screw loosening (two high quality studies), adjacent segment degeneration (three high quality studies) and proximal junctional kyphosis (five high quality studies) after lumbar surgery. Besides, there is also limited evidence for association between atrophy and FI of paraspinal extensor muscles and less local and global curve improvement. Conclusions Strong evidence was found for an association between preoperative paraspinal muscle degeneration and multiple postoperative complications after lumbar surgery. However, the findings should be interpreted with caution due to the small quantity of the available literature and high heterogeneity among studies.

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Psoas cross-sectional area as a predictor of mortality and a diagnostic tool for sarcopenia in hip fracture patients

Cited by 30 publications

References 29 publications

Paediatric reference values for total psoas muscle area

Paediatric reference values for total psoas muscle area

Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review

The predictive value of preoperative paraspinal muscle morphometry on complications after lumbar surgery: a systematic review

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