PD1048 - ASSOCIATION BETWEEN EVACUATION PATHWAY AND MUSCLE MASS LOSS AFTER COMBAT TRAUMA

PD1048

ASSOCIATION BETWEEN EVACUATION PATHWAY AND MUSCLE MASS LOSS AFTER COMBAT TRAUMA

M. Farmaha^1,*, D. Turkevych¹, I. Hanchuk¹, I. Hul¹, A. Vilenskyi¹

¹Superhumans War Trauma Center, Lviv, Ukraine

Rationale: In war, delayed access to specialized care and high protein and energy demands due to early post-traumatic catabolism may contribute to muscle loss not reflected by body mass index (BMI). This study assessed the association between time to admission to a surgical facility and body composition indicators in patients with severe combat injuries.

Methods: An observational comparative study included 37 patients with severe mine-blast limb injuries evacuated to a trauma center between February – March 2026. Patients were categorized into two groups: targeted evacuation to a specialized center; n=11; stepwise evacuation through ≥2 healthcare facilities (n=26). Baseline characteristics were comparable between groups. Nutritional risk was assessed using NRS-2002, with GLIM criteria applied for the diagnosis of malnutrition. Estimated BMI (eBMI), corrected arm muscle area (cAMA), mid-upper arm fat area (MAFA), and laboratory parameters (albumin, hemoglobin, lymphocyte count, C-reactive protein) were analyzed. Nutritional support was not provided during evacuation.

Results: Mean time to admission was 1.5 days in the targeted group and 9.5 days in the stepwise group. Mean age, BMI and nutritional screening scores were  comparable between groups (Age: 35.6 vs 35.5 years; BMI 26.4 vs 26.5 kg/m²; NRS-2002 2.8 vs 2.7; GLIM-based score 2.2 vs 2.1). Despite similar BMI and inflammatory response (comparable C-reactive protein levels), the stepwise evacuation group demonstrated lower muscle mass (cAMA 57.0 vs 60.2 cm²) and relatively higher fat mass (MAFA 20.1 vs 14.4 cm²). Albumin, hemoglobin, and lymphocyte levels were lower in the stepwise evacuation group.

Conclusion: Targeted evacuation patients reached specialized care earlier and demonstrated better preservation of muscle mass. Early access to multidisciplinary specialized care may contribute to better preservation of muscle mass after severe combat trauma.

Disclosure of Interest: None declared