Elizabeth Auckley BA 1 Deeya Sharma 2 Stephen J Kaplan MD MPH 3 Tam N Pham MD 4 Donald Mack MD FAAFP 5 May Reed MD FACP 3 Itay Bentov MD PhD 6 1 ID: 931037
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Slide1
Prospective Measurement of Sarcopenia with Masseter Muscle Ultrasound in Elderly Trauma Patients
Elizabeth Auckley, B.A.
1, Deeya Sharma2, Stephen J. Kaplan, MD MPH3, Tam N. Pham, MD4, Donald Mack, MD FAAFP,5 May Reed, MD F.A.C.P.3, Itay Bentov, MD PhD61The Ohio State University College of Medicine, Columbus, OH 2University of Washington, Seattle, WA, 3Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, WA, 4Department of Surgery, University of Washington, Seattle, WA, 5 Department of Family Medicine, The Ohio State University College of Medicine, Columbus, OH. 6Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
Methods
Results
References
This research was funded by The Medical Student Training in Aging Research Program, the National Institute on Aging (T35AG026736), and the Lillian R.
Gleitsman
Foundation.
Masseter CSA
Conclusions
Acknowledgements
Background
Recruitment
Trauma
Head CT
Muscle Mass
Ultrasound CSA
CT CSA
Frailty
Clinical Frailty Score
FRAIL Score
Fried Phenotype
Outcomes
Sarcopenia and Frailty Correlation
Length of Stay
Discharge Disposition
Trauma outcomes worsen significantly with age
1
Frailty is a reduced reserve to respond to stressors
2
Increases risk for morbidity and mortality
Evaluation requires patient participation
3
Need for an objective predictor of frailty in older trauma patients that does not require engagement
Hypothesis:
Masseter muscle ultrasound will be useful in
identifying sarcopenia and frailtypredicting poor outcomes in older trauma patients
Masseter Dynamic Change
CT CSA Q1
(n=14)
CT CSA Q4
(n=11)
Length of Stay
10
± 8.6
3.9 ± 2.7
p = 0.01
A smaller masseter dynamic change correlated to increased frailty and malnutrition
A smaller masseter CSA measured on CT correlated to longer length of stay
Ultrasound of masseter muscle has potential for determining sarcopenia and frailty
Goodmanson
NW, et al: Defining geriatric trauma: when does age make a difference? Surgery 2012; 152: 668-675
Morley Je, et al: Frailty consensus: a call to action. J Am Med Dir
Assoc
2013; 14: 392-7
Fried LP, et al: Frailty in Older Adults: Evidence for a Phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2001; 56: M146-M157
Bentov
I, et al. Frailty assessment: from clinical to radiological tools.
Br J
Anaesth
.
2019;123(1):37-50.
Female
(n=22)
Male
(n=36)
Total
(n=58)
Age
60.8 ± 19.1
64.6 ± 16.763.2 ± 17.6BMI29.4 ± 8.128.2 ± 7.428.8 ± 7.6CFS-93.6 ± 1.5 3.3 ± 1.73.4 ± 1.6Nutritional Status (MNA)10.1 ± 2.211.4 ± 2.410.9 ± 2.4Polypharmacy5.2 ± 5.54.8 ± 3.74.9 ± 4.4Injury Severity Score5.1 ± 2.35.6 ± 3.75.4 ± 3.2Charleston Comorbidity3.2 ± 2.23.1 ± 2.03.1 ± 2.1Length of Stay5.3 ± 3.36.8 ± 6.76.2 ± 5.7Pre-Trauma DispositionHome: 100%Home: 100%Home: 100%Discharge DispositionHome: 71%Home Aid: 0%SNF: 29%Home: 65%Home Aid: 10%SNF: 25%Home: 68%Home Aid: 6%SNF: 26%
Masseter Dynamic Change correlated to Malnutrition and Frailty
US Dynamic Change
Q1
(n=14)US Dynamic Change Q4(n=14)MNA Score9.9 ± 2.711.7 ± 1.6p = 0.04CFS9 Score4.2 ± 1.53.1 ± 1.6p = 0.05
Masseter CT CSA is related to Length of Stay
4
Muscle Function
Ultrasound Dynamic Change
Hand Grip Strength
CovariatesDentition and NutritionComorbiditiesPolypharmacy
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