Subarachnoid Hemorrhage and Temporal Muscle Thickness as a surrogate marker for sarcopenia: A possible and easily accessible prognostic CT-marker for patient's course of disease and neurological outcome
Emad Mohajerani (Essen), Meltem Gümüs (Essen), Thiemo F. Dinger (Essen), Christoph Rieß (Essen), Marvin Darkwah Oppong (Essen), Yahya Ahmadipour (Essen), Philipp Dammann (Essen), Karsten H. Wrede (Essen), Ulrich Sure (Essen), Ramazan Jabbarli (Essen)
Sarcopenia has already been investigated as a prognostic marker for many different cancerous and non-cancerous diseases to prognosticate the clinical course. Temporal muscle thickness (TMT), as a representative of sarcopenia, and therefore also as a possible marker for clinical outcome, has gained increasing interest in recent years. The aim of this retrospective study was to investigate the association between TMT and the neurological outcome of patients with aneurysmal subarachnoid hemorrhage (aSAH).
A retrospective database consisting of all consecutive aSAH cases treated from 01/2003 to 06/2016 was used. The initial computed tomography examinations were used to calculate the mean TMT values. Primary endpoints included in-hospital mortality, development of cerebral infarcts and unfavorable outcome at 6 months defined as modified Rankin Scale >3. Secondary endpoints included occurrence of angiographic vasospasm, intracranial hypertension (>20mmHg) and systemic infections during aSAH. Univariate analyses were conducted and multivariate analyses were performed on significant findings.
The mean TMT value of the final cohort (n=937) was 7.49mm ±1.68mm. Of the baseline characteristics, a significant relationship with TMT mean value was found for age (p < 0.0001), sex (p < 0.0001), obesity (p = 0.001) and uricemia/gout (p = 0.026). In the final multivariate analysis, the following aSAH endpoints/adverse events were independently associated with TMT: in-hospital mortality (p = 0.035, adjusted odds ratio [aOR] 0.86 per-mm-increase, 95% confidence interval [CI] 0.75-0.99), unfavorable outcome at 6 months (p = 0.018, aOR 0.86, 95% CI 0.76-0.98), intracranial hypertension (p = 0.002, aOR, 1.17, 95% CI 1.06-1.29) and the occurrence of angiographic vasospasm (p = 0.011, aOR, 0.87, 95% CI 0.78-0.97).
In this study, we found significant correlations between TMT mean value and the clinical course/outcome of patients affected by aSAH. Further studies in different patient populations are needed to validate the clinical relevance and prognostic value of TMT for aSAH patients.
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