Are Sarcopenia and Myosteatosis in Elderly Patients with Pelvic Ring Injury Related to Mortality, Physical Functioning and Quality of Life?

Hester Banierink,Erik Heineman,Sven H Van Helden,Inge H F Reininga,Kaj Ten Duis,Julia J C Bombach,Robert J Nijveldt,Frank F A Ijpma,Alain R Viddeleer

doi:10.3390/jcm10214874

Hester Banierink, Erik Heineman + Show 7 more

Open Access

https://doi.org/10.3390/jcm10214874

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Abstract

The purpose of this study was to evaluate the prevalence of sarcopenia and/or myosteatosis in elderly patients with pelvic ring injuries and their influence on mortality, patient-perceived physical functioning and quality of life (QoL). A multicenter retrospective cohort study was conducted including elderly patients aged ≥ 65 treated for a pelvic ring injury. Cross-sectional computed tomography (CT) muscle measurements were obtained to determine the presence of sarcopenia and/or myosteatosis. Kaplan–Meier analysis was used for survival analysis, and Cox proportional hazards regression analysis was used to determine risk factors for mortality. Patient-reported outcome measures for physical functioning (SMFA) and QoL (EQ-5D) were used. Multivariable linear regression analyses were used to determine the effect of sarcopenia and myosteatosis on patient-perceived physical functioning and QoL. Data to determine sarcopenia and myosteatosis were available for 199 patients, with a mean follow-up of 2.4 ± 2.2 years: 66 patients (33%) were diagnosed with sarcopenia and 65 (32%) with myosteatosis, while 30 of them (15%) had both. Mortality rates in patients at 1 and 3 years without sarcopenia and myosteatosis were 13% and 21%, compared to 11% and 36% in patients with sarcopenia, 17% and 31% in patients with myosteatosis and 27% and 43% in patients with both. Higher age at the time of injury and a higher Charlson Comorbidity Index (CCI) were independent risk factors for mortality. Patient-reported mental and emotional problems were significantly increased in patients with sarcopenia.

Highlights

Pelvic ring injuries in frail elderly patients are a growing health concern as the population ages
We subsequently evaluated the association between the presence of sarcopenia and/or myosteatosis in patients with pelvic ring injuries and mortality, physical functioning and quality of life (QoL)
For 199 (55%) of these patients, the necessary data were available to determine the presence of sarcopenia and myosteatosis

Summary

Introduction

Pelvic ring injuries in frail elderly patients are a growing health concern as the population ages. Known as aging-related physiological decline, is characterized by vulnerability to adverse health outcomes. A surrogate measure of frailty is the gradual decline in skeletal muscle mass and strength (sarcopenia), which can act synergistically with an increase in intermuscular and intramuscular fat (myosteatosis). The exact mechanisms of sarcopenia and myosteatosis are still unknown, but both have been associated with aging and inactivity. It is estimated that up to 25% of persons under age 70 and over 50% of those 80 or older have sarcopenia [2]. Due to the rapidly expanding aging population, it is roughly estimated that sarcopenia will affect over 200 million people worldwide in the 30 years [3]

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