Psoas muscle indices, visceral fat distribution, inflammatory markers and 90-day mortality in palliative medicine: retrospective cohort study

OBJECTIVE: The aim of this study is to evaluate the prognostic value of CT-based body composition parameters (skeletal muscle quantity and muscle quality), fat distribution, Global Leadership Initiative on Malnutrition (GLIM) malnutrition criteria and inflammatory/metabolic markers (C-reactive protein/albumin ratio (CAR) and triglyceride-glucose (TyG) index) on 90-day mortality. METHODS: A total of 118 patients admitted to the palliative care unit between January 2020 and December 2021 were included in the study. The Psoas Area Index (PAI), Psoas Density Index (PDI) and visceral/subcutaneous fat area ratio were calculated from CT images at the L3 vertebra level. Malnutrition diagnosis was established according to GLIM criteria. Independent risk factors associated with 90-day mortality were evaluated using multivariate logistic regression analysis, and model performance was validated using the 1000-repetition bootstrap method. RESULTS: Out of 118 patients, the 90-day mortality rate was 39.8% (n=47). In deceased patients, PAI (5.4±1.2 vs 6.9±1.4 cm²/m²) and PDI (33.8±7.5 vs 39.5±7.0 HU (Hounsfield unit)) values were significantly lower (p