한빛사논문
- 조회639
Youn-Jung Kim1, Dong-Woo Seo1, Yousun Ko2, Seok-In Hong1, Kyung Won Kim3* & Won Young Kim1*
1Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea; 2Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea; 3Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
*Corresponding author.
Abstract
Background
The aim of this study was to evaluate prognostic value of body tissue composition at the upper thigh level for 1 year mortality in elderly patients with proximal femur fracture.
Methods
This retrospective cohort study included consecutive elderly (aged ≥65) patients diagnosed with proximal femur fracture based on the findings of pelvic bone computed tomography (CT) performed at the emergency department of a tertiary care hospital and treated with surgery between 2010 and 2017. The cross-sectional area of subcutaneous fat and skeletal muscle at the upper thigh level was measured using CT. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for 1 year mortality were estimated using a Cox proportional hazards model. Survival based on the SFA quartiles was assessed using nonparametric Kaplan–Meier survival analysis and compared used log-rank tests.
Results
Among 876 elderly patients included in this study, the median age was 79.0 years, and 646 (73.7%) patients were female. A total of 93 (10.6%) died within 1 year after admission to the emergency department. Survivors had a significantly higher median subcutaneous fat area (SFA) than non-survivors (170.2 vs. 133.0 cm2, P < 0.001), but no significant difference was observed between the skeletal muscle area (median, 156.7 vs. 160.3 cm2, P = 0.504) and muscle density (median, 19.0 vs. 19.1 HU, P = 0.861) of both groups. After adjustment of other clinical characteristics and body compositions, the multivariate Cox proportional hazard analysis showed that SFA (adjusted HR, 0.987; 95% CI, 0.982–0.992; P < 0.001) was independently associated with 1 year mortality. With 384 deaths during 51 322 person-months of follow-up, the median estimated survival duration of all the patients was 92.8 months (95% CI, 80.8–104.7 months). The patients with SFA in the third (165.6–195.0 cm2) and fourth (>195.0 cm2) quartiles showed significantly longer survival duration than those with SFA in the first (<131.4 cm2; median survival time, 51.3 months) and second (131.4–165.5 cm2; median survival time, 88.7 months) quartiles (P < 0.001 by log-rank test).
Conclusions
The SFAs measured at the upper thigh level and 1 year mortality are positively associated in elderly patients with proximal femur fracture. SFA may be an independent prognostic biomarker for 1 year mortality of femur fracture.
논문정보
- Research article
- 2021년 10월 (BRIC 등록일 2021-11-23)
- 국내 연구진
- 의약학 > 응용의학
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