PP471
SKELETAL MUSCLE PARAMETERS DERIVED FROM CHEST CT FOR EVALUATING ADVERSE PROGNOSIS AND DEVELOPING A NOMOGRAM IN GERIATRIC PNEUMONIA PATIENTS
C. Chen1,*, X. Shen1, W. Sun1, J. Guan1
1The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Rationale: Geriatric pneumonia presents prominent prognostic heterogeneity. As a core phenotype of age-related skeletal muscle dysfunction, myosteatosis has an unclear predictive value for adverse clinical outcomes in geriatric pneumonia patients. This study aimed to clarify its clinical significance and establish an efficient prognostic model.
Methods: This dual-center retrospective observational cohort study enrolled 931 pneumonia patients aged ≥60 years from two tertiary hospitals between March 2020 and March 2023. Skeletal muscle area, density and index at T5/T12 levels were measured via chest CT. Logistic regression and LASSO regression were used to screen variables and construct a nomogram for in-hospital mortality risk, whose performance was validated by calibration curves, ROC curves and DCA.
Results: Myosteatosis was an independent risk factor for in-hospital mortality, ICU admission and invasive mechanical ventilation in geriatric pneumonia patients (all P<0.05). The established nomogram achieved a C-index of 0.80, with significantly better predictive performance than PSI and CURB-65 scoring systems. Subgroup analyses confirmed that the predictive value of myosteatosis remained robust across all clinical strata.
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Conclusion: Myosteatosis quantified by chest CT can independently predict adverse prognosis in geriatric pneumonia. The nomogram incorporating this indicator has excellent clinical application value, and myosteatosis is recommended to be included in the routine prognostic stratification system for geriatric pneumonia.
Disclosure of Interest: None declared