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Background <p>Frailty is associated with&#xa0;poor&#xa0;clinical outcomes in patients with pleural infections. Body composition, measured using computed tomography (CT), is an objective,&#xa0;patient-specific factor in the frailty index and&#xa0;a strong&#xa0;predictor of mortality in critically ill patients.&#xa0;Therefore, this study aimed to investigate the association between body composition and 1-year mortality in patients with pleural infections.</p> Methods <p>We retrospectively reviewed the medical records of patients with pleural infections between January 2010 and December 2019.&#xa0;Chest CT scans at the fourth (T4) vertebra level were analyzed using SliceOmatic software to measure&#xa0;the cross-sectional skeletal muscle&#xa0;area and the intramuscular fat area. The skeletal muscle index (SMI) and the intramuscular fat index (IMFI) were calculated by normalizing muscle and fat areas to height squared. The fat-to-muscle ratio (FMR) was derived by dividing the IMFI by the SMI. Sex-specific cutoffs for low SMI or high FMR were used to define thoracic sarcopenia. Time to death was compared between patients with and without thoracic sarcopenia using Kaplan − Meier survival analysis and log-rank tests. Cox regression was used to evaluate independent predictors of 1-year mortality.</p> Results <p>In total, 303 patients hospitalized for pleural infections were included. The 1-year mortality rate was higher in patients with thoracic sarcopenia than in those without sarcopenia. Multivariable Cox regression analyses revealed an independent association between thoracic sarcopenia and 1-year mortality rate (low SMI: hazard ratio [HR], 6.04; 95% confidence interval [CI], 3.65 − 11.25; <i>P</i> = 0.001; high FMR: HR, 2.30; 95% CI, 1.45 − 3.66; <i>P</i> = 0.001).</p> Conclusions <p>Thoracic sarcopenia is independently associated with an increased risk of 1-year mortality in patients with pleural infection. Therefore, evaluating thoracic sarcopenia on admission for patients with pleural infection is crucial.</p>

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CT-assessed thoracic sarcopenia as an independent prognostic marker in patients with pleural infections: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月24日

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  • Jimi Oh,
  • Chul Park,
  • Yunho Kang,
  • Seung Won Ra

摘要

Background

Frailty is associated with poor clinical outcomes in patients with pleural infections. Body composition, measured using computed tomography (CT), is an objective, patient-specific factor in the frailty index and a strong predictor of mortality in critically ill patients. Therefore, this study aimed to investigate the association between body composition and 1-year mortality in patients with pleural infections.

Methods

We retrospectively reviewed the medical records of patients with pleural infections between January 2010 and December 2019. Chest CT scans at the fourth (T4) vertebra level were analyzed using SliceOmatic software to measure the cross-sectional skeletal muscle area and the intramuscular fat area. The skeletal muscle index (SMI) and the intramuscular fat index (IMFI) were calculated by normalizing muscle and fat areas to height squared. The fat-to-muscle ratio (FMR) was derived by dividing the IMFI by the SMI. Sex-specific cutoffs for low SMI or high FMR were used to define thoracic sarcopenia. Time to death was compared between patients with and without thoracic sarcopenia using Kaplan − Meier survival analysis and log-rank tests. Cox regression was used to evaluate independent predictors of 1-year mortality.

Results

In total, 303 patients hospitalized for pleural infections were included. The 1-year mortality rate was higher in patients with thoracic sarcopenia than in those without sarcopenia. Multivariable Cox regression analyses revealed an independent association between thoracic sarcopenia and 1-year mortality rate (low SMI: hazard ratio [HR], 6.04; 95% confidence interval [CI], 3.65 − 11.25; P = 0.001; high FMR: HR, 2.30; 95% CI, 1.45 − 3.66; P = 0.001).

Conclusions

Thoracic sarcopenia is independently associated with an increased risk of 1-year mortality in patients with pleural infection. Therefore, evaluating thoracic sarcopenia on admission for patients with pleural infection is crucial.