Skeletal Muscle as a Factor Contributing to Better Stratification of Older Patients with Traumatic Brain Injury: A Retrospective Cohort Study.

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 (age ≥60 years) with TBI were included in this study. Clinical outcomes were assessed using the Glasgow Outcome Scale (GOS) at 6 months postinjury. Patients were classified according to their GOS score as having a good outcome (GOS 3-5) or a poor outcome (GOS 1 OR 2). 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 the risk of poor outcome.

RESULTS: Seventy-four patients (median age, 74 years; 53 males) were included. Outcomes at 6 months postinjury were good in 38 patients and poor in 36 patients. The skeletal muscle area was significantly larger in the good outcome group compared with the poor outcome group (57.3 cm2 vs. 47.6 cm2 ; P < 0.001). The rate of poor outcome was significantly higher in the patients with sarcopenia compared with those without sarcopenia (0.70 vs. 0.24; relative risk, 2.98; 95% confidence interval [CI], 1.57-5.64). The difference was statistically 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 our cohort of older patients. Our results suggest that identifying patients with low muscularity may contribute to better stratification in this population.