Abstract
Background: Opportunistic assessment of sarcopenia on CT examinations is becoming increasingly common. This study aimed to determine relationships between CT-measured skeletal muscle size and attenuation with 1-year risk of mortality in older adults enrolled in a Medicare Shared Savings Program (MSSP). Methods: Relationships between skeletal muscle metrics and all-cause mortality were determined in 436 participants (52% women, mean age 75 years) who had abdominopelvic CT examinations. On CT images, skeletal muscles were segmented at the level of L3 using two methods: (a) all muscles with a threshold of-29 to +150 Hounsfield units (HU), using a dedicated segmentation software, (b) left psoas muscle using a free-hand region of interest tool on a clinical workstation. Muscle cross-sectional area (CSA) and muscle attenuation were measured. Cox regression models were fit to determine the associations between muscle metrics and mortality, adjusting for age, sex, race, smoking status, cancer diagnosis, and Charlson comorbidity index. Results: Within 1 year of follow-up, 20.6% (90/436) participants died. In the fully-adjusted model, higher muscle index and muscle attenuation were associated with lower risk of mortality. A one-unit standard deviation (SD) increase was associated with a HR = 0.69 (95% CI = 0.49, 0.96; p =.03) for total muscle index, HR = 0.67 (95% CI = 0.49, 0.90; p <.01) for psoas muscle index, HR = 0.54 (95% CI = 0.40, 0.74; p <.01) for total muscle attenuation, and HR = 0.79 (95% CI = 0.66, 0.95; p =.01) for psoas muscle attenuation. Conclusion: In older adults, higher skeletal muscle index and muscle attenuation on abdominopelvic CT examinations were associated with better survival, after adjusting for multiple risk factors.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1063-1069 |
| Number of pages | 7 |
| Journal | Journals of Gerontology - Series A Biological Sciences and Medical Sciences |
| Volume | 74 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jun 18 2019 |
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Keywords
- Computed tomography
- Electronic health records
- Medical informatics
- Myosteotosis
- Sarcopenia
ASJC Scopus subject areas
- Aging
- Geriatrics and Gerontology
Cite this
Opportunistic Measurement of Skeletal Muscle Size and Muscle Attenuation on Computed Tomography Predicts 1-Year Mortality in Medicare Patients. / Lenchik, Leon; Lenoir, Kristin M.; Tan, Josh; Boutin, Robert D; Callahan, Kathryn E.; Kritchevsky, Stephen B.; Wells, Brian J.
In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 74, No. 7, 18.06.2019, p. 1063-1069.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Opportunistic Measurement of Skeletal Muscle Size and Muscle Attenuation on Computed Tomography Predicts 1-Year Mortality in Medicare Patients
AU - Lenchik, Leon
AU - Lenoir, Kristin M.
AU - Tan, Josh
AU - Boutin, Robert D
AU - Callahan, Kathryn E.
AU - Kritchevsky, Stephen B.
AU - Wells, Brian J.
PY - 2019/6/18
Y1 - 2019/6/18
N2 - Background: Opportunistic assessment of sarcopenia on CT examinations is becoming increasingly common. This study aimed to determine relationships between CT-measured skeletal muscle size and attenuation with 1-year risk of mortality in older adults enrolled in a Medicare Shared Savings Program (MSSP). Methods: Relationships between skeletal muscle metrics and all-cause mortality were determined in 436 participants (52% women, mean age 75 years) who had abdominopelvic CT examinations. On CT images, skeletal muscles were segmented at the level of L3 using two methods: (a) all muscles with a threshold of-29 to +150 Hounsfield units (HU), using a dedicated segmentation software, (b) left psoas muscle using a free-hand region of interest tool on a clinical workstation. Muscle cross-sectional area (CSA) and muscle attenuation were measured. Cox regression models were fit to determine the associations between muscle metrics and mortality, adjusting for age, sex, race, smoking status, cancer diagnosis, and Charlson comorbidity index. Results: Within 1 year of follow-up, 20.6% (90/436) participants died. In the fully-adjusted model, higher muscle index and muscle attenuation were associated with lower risk of mortality. A one-unit standard deviation (SD) increase was associated with a HR = 0.69 (95% CI = 0.49, 0.96; p =.03) for total muscle index, HR = 0.67 (95% CI = 0.49, 0.90; p <.01) for psoas muscle index, HR = 0.54 (95% CI = 0.40, 0.74; p <.01) for total muscle attenuation, and HR = 0.79 (95% CI = 0.66, 0.95; p =.01) for psoas muscle attenuation. Conclusion: In older adults, higher skeletal muscle index and muscle attenuation on abdominopelvic CT examinations were associated with better survival, after adjusting for multiple risk factors.
AB - Background: Opportunistic assessment of sarcopenia on CT examinations is becoming increasingly common. This study aimed to determine relationships between CT-measured skeletal muscle size and attenuation with 1-year risk of mortality in older adults enrolled in a Medicare Shared Savings Program (MSSP). Methods: Relationships between skeletal muscle metrics and all-cause mortality were determined in 436 participants (52% women, mean age 75 years) who had abdominopelvic CT examinations. On CT images, skeletal muscles were segmented at the level of L3 using two methods: (a) all muscles with a threshold of-29 to +150 Hounsfield units (HU), using a dedicated segmentation software, (b) left psoas muscle using a free-hand region of interest tool on a clinical workstation. Muscle cross-sectional area (CSA) and muscle attenuation were measured. Cox regression models were fit to determine the associations between muscle metrics and mortality, adjusting for age, sex, race, smoking status, cancer diagnosis, and Charlson comorbidity index. Results: Within 1 year of follow-up, 20.6% (90/436) participants died. In the fully-adjusted model, higher muscle index and muscle attenuation were associated with lower risk of mortality. A one-unit standard deviation (SD) increase was associated with a HR = 0.69 (95% CI = 0.49, 0.96; p =.03) for total muscle index, HR = 0.67 (95% CI = 0.49, 0.90; p <.01) for psoas muscle index, HR = 0.54 (95% CI = 0.40, 0.74; p <.01) for total muscle attenuation, and HR = 0.79 (95% CI = 0.66, 0.95; p =.01) for psoas muscle attenuation. Conclusion: In older adults, higher skeletal muscle index and muscle attenuation on abdominopelvic CT examinations were associated with better survival, after adjusting for multiple risk factors.
KW - Computed tomography
KW - Electronic health records
KW - Medical informatics
KW - Myosteotosis
KW - Sarcopenia
UR - http://www.scopus.com/inward/record.url?scp=85054703240&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054703240&partnerID=8YFLogxK
U2 - 10.1093/gerona/gly183
DO - 10.1093/gerona/gly183
M3 - Article
VL - 74
SP - 1063
EP - 1069
JO - The journals of gerontology. Series A, Biological sciences and medical sciences
JF - The journals of gerontology. Series A, Biological sciences and medical sciences
SN - 1079-5006
IS - 7
ER -