BackgroundBody composition parameters provide relevant prognostic significance in critical care cohorts and cancer populations. Published results regarding polytrauma patients are inconclusive to date. The goal of this study was to analyse the role of body composition parameters in severely injured trauma patients.MethodsAll consecutive patients requiring emergency tracheal intubation and mechanical ventilation before initial computed tomography (CT) at a level‐1 trauma centre over a 12‐year period (2008–2019) were reanalysed. The analysis included CT‐derived body composition parameters based upon whole‐body trauma CT as prognostic variables for 30‐day mortality, intensive care unit length of stay (ICU LOS) and mechanical ventilation duration.ResultsFour hundred seventy‐two patients (75% male) with a median age of 49 years, median injury severity score of 26 and 30‐day mortality rate of 22% (104 patients) met the inclusion criteria and were analysed. Regarding body composition parameters, 231 patients (49%) had visceral obesity, 75 patients had sarcopenia (16%) and 35 patients had sarcopenic obesity (7.4%). After adjustment for statistically significant univariable predictors age, body mass index, sarcopenic obesity, visceral obesity, American Society of Anesthesiologists classification ≥3, injury severity score and Glasgow Coma Scale ≤ 8 points, the Cox proportional hazard model identified sarcopenia as significant prognostic factor of 30‐day mortality (hazard ratio 2.84; 95% confidence interval 1.38–5.85; P = 0.004), which was confirmed in Kaplan–Meier survival analysis (log‐rank P = 0.006). In a subanalysis of 363 survivors, linear multivariable regression analysis revealed no significant associations of body composition parameters with ICU LOS and duration of mechanical ventilation.ConclusionsIn a multivariable analysis of mechanically ventilated trauma patients, CT‐defined sarcopenia was significantly associated with 30‐day mortality whereas no associations of body composition parameters with ICU LOS and duration of mechanical ventilation were observed.

中文翻译：

---

机械通气创伤患者初始 CT 成像中的身体成分参数：单中心观察性研究


背景身体成分参数为重症监护人群和癌症人群提供相关的预后意义。迄今为止，关于多发伤患者的已发表结果尚无定论。本研究的目的是分析身体成分参数在严重受伤创伤患者中的作用。方法 12 年期间，在 1 级创伤中心首次计算机断层扫描 (CT) 之前需要紧急气管插管和机械通气的所有连续患者（2008-2019）进行了重新分析。该分析包括基于全身创伤 CT 的 CT 衍生身体成分参数作为 30 天死亡率、重症监护病房住院时间 (ICU LOS) 和机械通气持续时间的预后变量。 结果 472 名患者（75% 为男性） ），中位年龄为 49 岁，中位损伤严重程度评分为 26，30 天死亡率为 22%（104 名患者）符合纳入标准并进行了分析。在身体成分参数方面，231名患者（49%）患有内脏肥胖，75名患者患有肌肉减少症（16%），35名患者患有肌肉减少症肥胖（7.4%）。对具有统计显着性的单变量预测因素年龄、体重指数、肌少症性肥胖、内脏性肥胖、美国麻醉医师协会分类≥3、损伤严重程度评分和格拉斯哥昏迷量表≤8分进行调整后，Cox比例风险模型将肌少症确定为显着的预后因素30 天死亡率（风险比 2.84；95% 置信区间 1.38-5.85；P = 0.004），这一点在 Kaplan-Meier 生存分析中得到证实（对数秩 P = 0.006）。 在对 363 名幸存者进行的亚分析中，线性多变量回归分析显示，身体成分参数与 ICU LOS 和机械通气持续时间没有显着相关性。结论在对机械通气创伤患者的多变量分析中，CT 定义的肌少症与 30 天死亡率显着相关而没有观察到身体成分参数与 ICU LOS 和机械通气持续时间的关联。