Analysis of Muscle Using CT Anthropometry in Major Trauma Patients

Purpose: The feasibility of nutritional assessment using computed tomography anthropometry has been previously proven. The abdominal muscle at the L3 vertebra is a well-known nutritional biomarker for predicting the prognosis of various diseases, and especially sarcopenia. However, any studies on nutritional assessment of the brain, face, or neck via computed tomography are still scarce. We retrospectively investigated the applicability of the masseter muscle as a nutritional biomarker. Materials and Methods: Patients who underwent simultaneous brain and abdominopelvic computed tomography at a regional trauma center were retrospectively analyzed. Their masseter muscles at 2 cm below the zygomatic arch and abdominal muscle at L3 were assessed via computed tomography anthropometry. Basic clinical data including trauma information was also reviewed. The data was analyzed in conjunction with the patients’ mortality. Results: A total of 411 patients were analyzed in the study (316 men and 95 women, mean age: 50.41 years, mean areas of the masseter and abdominal muscles: 10.6 and 137.3 cm 2 , respectively) and there 146 major trauma patients with an injury severity score higher than 15. The masseter muscle area was decreased in the mortality group of major trauma patients (10.4 vs 7.9 cm 2 , P=0.001). However, abdominal muscles did not show statistical significance (137.9 vs. 117.7 cm 2 , P=0.054). Conclusion: The masseter muscle, when analyzed via computed tomography anthropometry, showed a statistical association with patients’ mortality and it could prove its feasibility as a nutritional biomarker. (Surg Metab Nutr 2020;11:12-15)