Image-based assessment of sarcopenic obesity predicts mortality in major trauma

Am J Surg. 2022 Apr;223(4):792-797. doi: 10.1016/j.amjsurg.2021.06.007. Epub 2021 Jun 18.


Background: Patients with obesity are also at risk for sarcopenia, which is difficult to recognize in this population. Our study examines whether sarcopenic-obesity (SO) is independently associated with mortality in trauma.

Methods: Using a retrospective database, we performed logistic regression analysis. . Admission CT scans were used to identify SO by calculating the visceral fat to skeletal muscle ratio >3.2.

Results: Of 883 patients, the prevalence of SO was 38% (333). Patients with SO were more likely to be male (79% versus 43%, p < 0.001), older (mean 66.5 years versus 46.3 years, p < 0.001), and less likely to have an injury severity score (ISS) ≥ 24 (43% versus 55%, p = 0.0003). Using multivariable logistic regression analysis, SO was independently associated with mortality (OR 2.8; 95% CI 1.6-4.8, p < 0.001). Causal mediation analysis found admission hyperglycemia as a mediator for mortality.

Conclusions: Sarcopenic obesity is an independent predictor of mortality in major trauma.

Keywords: Critical care; Diabetes; Obesity; Sarcopenia; Sarcopenic obesity; Trauma.

MeSH terms

  • Female
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging
  • Male
  • Muscle, Skeletal
  • Obesity / epidemiology
  • Retrospective Studies
  • Sarcopenia* / complications
  • Sarcopenia* / diagnostic imaging
  • Sarcopenia* / epidemiology