Sarcopenia Measured Using Masseter Area Predicts Early Mortality after Severe Traumatic Brain Injury

Sarcopenia is strongly associated with poor outcomes and mortality following injury among the geriatric population. Diagnosis using psoas area is most common, but may be unavailable given limited radiographic evaluation following low impact injuries. Masseter area (M-area) has recently been identified as an available alternative and associated with two year mortality following injury. We sought to validate this measure and its association with early mortality following severe TBI (sTBI) using a retrospective analysis of all geriatric trauma patients with sTBI admitted from 2011-2016 to an ACS verified level one trauma center. Admission Glasgow Coma Score (GCS) ≤8 was used to identify TBI. Bilateral masseter area was measured 2 cm below the zygomatic arch and the mean used for analysis. Sarcopenia was defined as mean M-area one standard deviation or less from the sex based mean. Analysis included chi-square or Student t-test, followed by multivariate analysis with logistic regression and Cox proportional h...