CT parameters of psoas muscle predicts 28-day mortality in older patients with sepsis: a retrospective study.

IF 3.4 2区医学 Q2 GERIATRICS & GERONTOLOGY

BMC Geriatrics Pub Date : 2024-11-19 DOI:10.1186/s12877-024-05559-0

Yun Wang, Tun Zhao, Min Liu, Wenli Hu

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引用次数: 0

Abstract

Odjectives: To investigate the predictive value of computed tomography (CT)-based transverse diameter (TD) and longitudinal diameter (LD) of the psoas muscle at the level of third lumbar vertebra for 28-day mortality in older patients with sepsis.

Methods: This retrospective single-center cohort study included 115 septic patients aged over 65 years old who were admitted to ICU in Beijing-Chaoyang Hospital between July 2017 and July 2022. The TD and LD of psoas muscle were obtained by measurement on abdominal CT images. Logistic regression analysis was conducted to identify the prognostic factors for 28-day mortality in older patients with sepsis, and their predictive performances were evaluated using the receiver operating characteristic (ROC) curve.

Results: Multivariable logistic analysis indicated that TD (OR: 0.405, 95% CI: 0.190-0.864) was a protective factor for 28-day mortality in older patients with sepsis, whereas LD was not. The areas under the curve (AUCs) of TD, APACHE II, and SOFA were 0.666 (95% CI: 0.565-0.767), 0.660 (95% CI: 0.561-0.760), and 0.679 (95% CI: 0.581-0.777), respectively. Furthermore, the AUCs for the combination of TD with APACHE II or SOFA were 0.766 (95% CI: 0.679-0.853, P < 0.001) and 0.765 (95% CI: 0.679-0.852, P < 0.001).

Conclusions: TD of psoas muscle was a predictor for 28-day mortality in older patients with sepsis. The combination of TD with APACHE II or SOFA scores enhances the early identification of patients at high risk for poor prognosis.

Clinical trial number: not applicable.

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腰肌 CT 参数可预测老年败血症患者 28 天的死亡率：一项回顾性研究。

目标研究基于计算机断层扫描（CT）的第三腰椎水平腰肌横径（TD）和纵径（LD）对老年脓毒症患者28天死亡率的预测价值：这项回顾性单中心队列研究纳入了2017年7月至2022年7月期间北京朝阳医院ICU收治的115名65岁以上脓毒症患者。通过腹部CT图像测量腰肌的TD和LD。通过逻辑回归分析确定老年脓毒症患者28天死亡率的预后因素，并利用接收器操作特征曲线（ROC）评估其预测性能：多变量逻辑分析表明，TD（OR：0.405，95% CI：0.190-0.864）是老年脓毒症患者 28 天死亡率的保护因素，而 LD 不是。TD、APACHE II 和 SOFA 的曲线下面积（AUC）分别为 0.666（95% CI：0.565-0.767）、0.660（95% CI：0.561-0.760）和 0.679（95% CI：0.581-0.777）。此外，TD 与 APACHE II 或 SOFA 结合的 AUC 值为 0.766（95% CI：0.679-0.853，P腰肌收缩压是老年败血症患者 28 天死亡率的预测因子。将TD与APACHE II或SOFA评分相结合，可加强对预后不良的高风险患者的早期识别。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Geriatrics GERIATRICS & GERONTOLOGY-

CiteScore

5.70

自引率

7.30%

发文量

873

审稿时长

20 weeks

期刊介绍： BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.