BACKGROUND: Traumatic brain injury (TBI) in older patients is becoming an increasing problem, and methods that help predict outcomes in this population are needed. The objective of this study was to evaluate skeletal muscle mass as a predictive marker for TBI outcome in older patients.
METHODS: Older patients (≥60 years) with TBI were included in this study and clinical outcome was assessed using the Glasgow Outcome Scale (GOS) at six months post-injury. Patients were classified according to their GOS score as having good outcome (GOS 3-5) or poor outcome (GOS 1 and 2). The skeletal muscle mass was estimated and the relationship with outcome was analyzed. A multivariable logistic regression model was used to quantify the independent effects of sarcopenia on poor outcome risk.
RESULTS: Seventy-four patients (median 74 years old; 53 men) were included. Outcomes six months post-injury were good in 38 patients and poor in 36 patients. The skeletal muscle area in the good outcome group was significantly larger than the poor outcome group (57.3 versus 47.6 cm(2), P < 0.001). The rate of poor outcome was significantly higher in patients with sarcopenia compared to those without (0.70 versus 0.24, relative risk = 2.98, 95% confidence interval (CI), 1.57-5.64). The difference was significant and the odds ratio was 3.88 (95% CI, 1.14-13.2, P = 0.031).
CONCLUSION: Reduced skeletal muscle mass was associated with poorer outcome after TBI in older patients. Our results suggest that identifying patients with low muscularity may contribute to better stratification in this population.