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Abstract
Erector spinae muscle (ESM) size has been reported as a predictor of prognosis in patients with some respiratory diseases. This study aimed to assess the association of ESM size on all-cause in-hospital mortality among elderly patients with pneumonia. We retrospectively included patients (age: ≥ 65 years) admitted to hospital from January 2015 to December 2017 for community-acquired pneumonia who underwent chest computed tomography (CT) on admission. The cross-sectional area of the ESM (ESMcsa) was measured on a single-slice CT image at the end of the 12th thoracic vertebra and adjusted by body surface area (BSA). Cox proportional hazards regression models were used to assess the influence of ESMcsa/BSA on in-hospital mortality. Among 736 patients who were admitted for pneumonia, 702 patients (95%) underwent chest CT. Of those, 689 patients (98%) for whom height and weight were measured to calculate BSA were included in this study. Patients in the non-survivor group were significantly older, had a greater frequency of respiratory failure, loss of consciousness, lower body mass index, hemoglobin, albumin, and ESMcsa/BSA. Multivariate analysis showed that a lower ESMcsa/BSA independently predicted in-hospital mortality after adjusting for these variables. In elderly patients with pneumonia, quantification of ESMcsa/BSA may be associated with in-hospital mortality.
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1 Oita University Faculty of Medicine, Department of Respiratory Medicine and Infectious Diseases, Yufu, Japan (GRID:grid.412334.3) (ISNI:0000 0001 0665 3553); Tenshindo Hetsugi Hospital, Department of Internal Medicine, Oita, Japan (GRID:grid.412334.3); Virginia Commonwealth University School of Medicine, Department of Pediatrics, Richmond, USA (GRID:grid.224260.0) (ISNI:0000 0004 0458 8737)
2 Oita University Faculty of Medicine, Department of Respiratory Medicine and Infectious Diseases, Yufu, Japan (GRID:grid.412334.3) (ISNI:0000 0001 0665 3553); Tenshindo Hetsugi Hospital, Department of Internal Medicine, Oita, Japan (GRID:grid.412334.3)
3 Tenshindo Hetsugi Hospital, Department of Internal Medicine, Oita, Japan (GRID:grid.412334.3)
4 Oita University Faculty of Medicine, Department of Respiratory Medicine and Infectious Diseases, Yufu, Japan (GRID:grid.412334.3) (ISNI:0000 0001 0665 3553)
5 Virginia Commonwealth University School of Medicine, Department of Pediatrics, Richmond, USA (GRID:grid.224260.0) (ISNI:0000 0004 0458 8737)
6 Oita University Faculty of Medicine, Department of Medical Safety Management, Yufu, Japan (GRID:grid.412334.3) (ISNI:0000 0001 0665 3553)
7 Oita University Faculty of Medicine, Department of Respiratory Medicine and Infectious Diseases, Yufu, Japan (GRID:grid.412334.3) (ISNI:0000 0001 0665 3553); Nagasaki Harbor Medical Center, Nagasaki, Japan (GRID:grid.412334.3)