• J Orthop Trauma · Jun 2018

    Sarcopenia Is Predictive of 1-Year Mortality After Acetabular Fractures in Elderly Patients.

    • Phillip M Mitchell, Cory A Collinge, David E OʼNeill, Jesse E Bible, and Hassan R Mir.
    • Florida Orthopaedic Institute, University of South Florida, Tampa, FL.
    • J Orthop Trauma. 2018 Jun 1; 32 (6): 278-282.

    ObjectivesTo determine whether sarcopenia is an independent predictor of mortality in geriatric acetabular fractures.DesignRetrospective cohort.SettingAmerican College of Surgeons Level I trauma center.Patients/ParticipantsOne hundred and forty-six patients over the age 60 with acetabular fractures treated at our institution over a 12-year period.Main Outcome MeasurementsThe primary outcome was 1-year mortality, collected using the Social Security Death Index. We used the psoas:lumbar vertebral index (PLVI), calculated using the cross-sectional area of the L4 vertebral body and the left and right psoas muscles, to assess for sarcopenia.ResultsUsing a multivariate logistic regression model, we found that low PLVI was associated with increased 1-year mortality (P = 0.046) when controlling for age, gender, Charlson Comorbidity Index, Injury Severity Score (ISS), smoking status, and associated pelvic ring injury. Increasing age and ISS also showed a relationship with 1-year mortality in this cohort (P < 0.001, P < 0.001, respectively). We defined sarcopenia as those patients in the lowest quartile of PLVI. The mortality rate of this cohort was 32.4%, compared with 11.0% in patients without sarcopenia (odds ratio 4.04; 95% confidence interval 1.62-10.1). Age >75 years, ISS >14, and sarcopenia had 1-year mortality rates of 37.1%, 30.9%, and 32.4%, respectively. In patients with all 3 factors, the mortality rate was 90%.ConclusionSarcopenia is an independent risk factor for 1-year mortality in elderly patients with acetabular fractures. This study highlights the importance of objective measures to assess frailty in elderly patients who have sustained fractures about the hip and pelvis.Level Of EvidencePrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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