Imaging Pearls ❯ Musculoskeletal ❯ Frailty Index
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- IMPORTANCE Prior studies demonstrated consistent associations of low skeletal musclemass assessed on surgical planning scans with postoperative morbidity and mortality. The increasing availability of imaging artificial intelligence enables development of morecomprehensive imaging biomarkers to objectively phenotype frailty in surgical patients.
OBJECTIVE To evaluate the associations of body composition scores derived from multipleskeletal muscle and adipose tissue measurements from automated segmentation of computed tomography (CT) with the Hospital Frailty Risk Score (HFRS) and adverse outcomes after abdominal surgery.
Automated CT Analysis of Body Composition as a Frailty Biomarker in Abdominal Surgery.
Fumagalli IA, Le ST, Peng PD, et al.
JAMA Surg. 2024 Jul 1;159(7):766-774. - CONCLUSIONS AND RELEVANCE In this study, higher muscle quantity and quality scores were correlated with frailty and associated with 30-day readmission and postoperative mortality and morbidity, whereas body size and adipose tissue distribution scores were not correlated with patient frailty and had inconsistent associations with surgical outcomes. The findings suggest that assessment of muscle quantity and quality on CT can provide an objective measure of patient frailty that would not otherwise be clinically apparent and that may complement existing risk stratification tools to identify patients at high risk of mortality, morbidity, and readmission.
Automated CT Analysis of Body Composition as a Frailty Biomarker in Abdominal Surgery.
Fumagalli IA, Le ST, Peng PD, et al.
JAMA Surg. 2024 Jul 1;159(7):766-774. - Key Points
Question: Can preoperative computed tomography (CT) scans provide patient frailty assessments that are associated with outcomes of abdominal surgery?
Findings: In this cohort study of 48 444 patients, scores reflecting the quantity and quality of skeletal muscle were strongly correlated with patient frailty and associated with 30-day readmission and postoperative mortality. Body size and adipose tissue distribution scores were not correlated with patient frailty and had inconsistent associations with surgical outcomes.
Meaning: The findings suggest that assessment of muscle quantity and quality via CT can provide an objective measure of patient frailty that may identify patients at high risk of mortality or readmission.
Automated CT Analysis of Body Composition as a Frailty Biomarker in Abdominal Surgery.
Fumagalli IA, Le ST, Peng PD, et al.
JAMA Surg. 2024 Jul 1;159(7):766-774. - “A core innovation of this work was the application of informatics and imaging artificial intelligence to derive novel body composition scores from routine clinical data (multislice CT performed for surgical planning). Specifically, we derived a muscle quantity and quality score as an imaging biomarker of patient frailty that was independently associated with morbidity and mortality after abdominal surgery.Muscle mass and quality is an appealing biomarker of frailty because it is a modifiable, underlying cause of the frailty phenotype (reduced physical function) and a downstream effect.”
Automated CT Analysis of Body Composition as a Frailty Biomarker in Abdominal Surgery.
Fumagalli IA, Le ST, Peng PD, et al.
JAMA Surg. 2024 Jul 1;159(7):766-774.