Sarcopenia Measured Using Masseter Area Predicts Early Mortality following Severe Traumatic Brain Injury

Parker Hu, Rindi Uhlich, Jared White, Jeffrey Kerby, Patrick Bosarge

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Sarcopenia is strongly associated with poor outcomes and mortality following injury among the geriatric population. Diagnosis using psoas area is most common but may be unavailable given limited radiographic evaluation following low-impact injuries. Masseter area has recently been identified as an available alternative and associated with 2-year mortality following injury. We sought to validate this measure and its association with early mortality following severe traumatic brain injury (sTBI) using a retrospective analysis of all geriatric trauma patients with sTBI admitted from 2011-2016 to our trauma center. Admission Glasgow Coma Scale (GCS) score ≤8 was used to identify sTBI. Bilateral masseter area was measured 2 cm below the zygomatic arch and the mean used for analysis. Sarcopenia was defined as mean masseter area one standard deviation or less from the sex-based mean. Multivariate models with logistic regression and Cox proportional hazards test followed univariate analysis. Kaplan-Meier survival curves were generated and evaluated by log rank. The primary outcome of interest was 30-day mortality. A total of 108 patients were identified for inclusion. Twenty-five patients, 16 male and nine female, had sarcopenia with mean masseter areas of 2.81 ± 0.45 cm2 and 2.24 ± 0.42 cm2, respectively. Patients with sarcopenia had significantly increased rates of 30-day mortality (80.0% vs. 50.6%; p = 0.01). Sarcopenia (odds ratio [OR], 2.95; 95% confidence interval [CI] 1.03-8.49) and decreasing masseter area were significantly associated with 30-day mortality (OR, 0.66; 95% CI 0.46-0.95) in multivariate modeling. Masseter area is a readily available and objective measure to determine sarcopenia, which is significantly associated with in-creased 30-day mortality following sTBI.

Original languageEnglish (US)
Pages (from-to)2400-2406
Number of pages7
JournalJournal of Neurotrauma
Volume35
Issue number20
DOIs
StatePublished - Oct 15 2018
Externally publishedYes

Keywords

  • Geriatric trauma
  • Sarcopenia
  • Traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Sarcopenia Measured Using Masseter Area Predicts Early Mortality following Severe Traumatic Brain Injury'. Together they form a unique fingerprint.

Cite this