{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T20:20:12Z","timestamp":1787430012475,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polytrauma patients with an Injury Severity Score (ISS)\u2009\u2265\u200916 have a high mortality rate. Early identification of patients at risk of mortality is key. Different risk stratification models are available; however, body composition on third lumbar computed tomography (L3 CT) is not routinely used. The aim of this study is to determine the effect of CT body composition on 1\u2010year mortality in adult polytrauma patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Body composition analysis (L3 CT) was performed on 593 adult polytrauma patients. The associations with 1\u2010year mortality were assessed using uni\u2010 and multivariable logistic regression analysis. As a sensitivity analysis, 1\u2010year mortality was analysed using Kaplan\u2013Meier survival curves, log\u2010rank tests and Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population was predominantly male (69.5%), with a mean age of 55 (\u00b120) years and an average BMI of 25.34\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (\u00b14.07). Comorbidities were present in 327 (55.4%) patients, with an average Charlson Comorbidity Index (CCI) of 2.07 points (\u00b12.1). The mean ISS score was 27.59 (\u00b111.06); 323 (54.5%) patients had an ISS\u2009\u2265\u200925 points. Age, CCI, ISS, skeletal muscle index and skeletal muscle radiation attenuation (OR 1.053, 5.713, 3.711, 0. 563 and 0.533, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), subcutaneous adipose tissue radiation attenuation (SATRA OR 1.253,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028) and visceral adipose tissue index (OR 1.242,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) were significantly associated with 1\u2010year mortality. In multivariable logistic regression, age, ISS and SATRA remained statistically significantly associated with 1\u2010year mortality (OR 1.062,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; OR 4.761,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; OR 1.396,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated that subcutaneous adipose tissue radiation attenuation on emergency trauma CT scans is significantly associated with 1\u2010year mortality in adult polytrauma patients. Additionally, we found a significant effect of age and ISS on 1\u2010year mortality. Incorporating body composition analysis could lead to a better selection of patients at risk for 1\u2010year mortality and aid in treatment decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13743","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T01:18:36Z","timestamp":1760404716000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Subcutaneous Adipose Tissue Radiation Attenuation Is Associated With Increased 1\u2010Year Mortality in Polytrauma Patients"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1583-7383","authenticated-orcid":false,"given":"Leanne\u00a0L.\u00a0G.\u00a0C.","family":"Ackermans","sequence":"first","affiliation":[{"name":"Department of Traumatology Maastricht University Medical Centre+  Maastricht The Netherlands"},{"name":"Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper\u00a0C.","family":"Stokroos","sequence":"additional","affiliation":[{"name":"Department of Traumatology Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David\u00a0P.\u00a0J.","family":"Van\u00a0Dijk","sequence":"additional","affiliation":[{"name":"Department of Surgery Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjorn","family":"Winkens","sequence":"additional","affiliation":[{"name":"Department of Methodology and Statistics, Faculty of Health, Medicine and Life Sciences Maastricht University  Maastricht"},{"name":"CAPHRI Care &amp; Public Health Research Institute Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Poeze","sequence":"additional","affiliation":[{"name":"Department of Traumatology Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Wee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Development Biology Maastricht University Medical Centre+  Maastricht The Netherlands"},{"name":"Clinical Data Science, Faculty of Health Medicine and Lifesciences Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Brecheisen","sequence":"additional","affiliation":[{"name":"Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven\u00a0M.\u00a0W.","family":"Olde\u00a0Damink","sequence":"additional","affiliation":[{"name":"Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre+  Maastricht The Netherlands"},{"name":"Department of General, Visceral and Transplantation Surgery RWTH University Hospital Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u00a0A.","family":"Ten\u00a0Bosch","sequence":"additional","affiliation":[{"name":"Department of Traumatology Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taco\u00a0J.","family":"Blokhuis","sequence":"additional","affiliation":[{"name":"Department of Traumatology Maastricht University Medical Centre+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-020-00330-3"},{"key":"e_1_2_9_3_1","unstructured":"Drs. 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