ABSTRACT
Objective: To provide pooled evidence on the association between central sarcopenia and risk of mortality and/or complications among geriatric patients with moderate to severe trauma. Methods: We conducted a systematic search in PubMed, EMBASE, and Scopus databases for relevant observational studies documenting the association of central sarcopenia with the risk of mortality and/or complications in geriatric patients with moderate to severe trauma. The studies reported computerized tomography (CT) based assessments of the psoas muscle cross-sectional area. We used a random effects model for the analysis and reported effect sizes as pooled odds ratios (ORs) or hazards ratios (HRs) along with 95% confidence intervals. Results: We analyzed data from 13 studies and found an association between the presence of psoas muscle size reduction and the risk of in-hospital mortality (OR, 1.47; 95% CI, 1.13, 1.90). In addition, we found increased risk of mortality within 24 months of follow-up in patients with sarcopenia (HR, 2.40; 95% CI, 1.11-5.17). We found each unit increase in psoas muscle cross-sectional area to be significantly associated with reduced risk of mortality within 24 months of follow-up (HR, .92; 95% CI, .90-.95). Patients with sarcopenia also had an increased risk of complications (OR, 1.69; 95% CI, 1.08-2.63). Conclusion: Central sarcopenia, assessed using psoas muscle morphology, among geriatric patients with moderate to severe trauma appears to be significantly associated with increased risks of mortality and complications.
ABSTRACT
The current investigation focuses on the stability of the magnesium oxide-based cementitious system under the action of sulfate attack and the dry-wet cycle. The phase change in the magnesium oxide-based cementitious system was quantitatively analyzed by X-ray diffraction, combined with thermogravimetry/derivative thermogravimetry and scanning electron microscope, to explore its erosion behavior under an erosion environment. The results revealed that, in the fully reactive magnesium oxide-based cementitious system under the environment of high concentration sulfate erosion, there was only magnesium silicate hydrate gel formation and no other phase; however, the reaction process of the incomplete magnesium oxide-based cementitious system was delayed, but not inhibited, by the environment of high-concentration sulfate, and it tended to turn completely into a magnesium silicate hydrate gel. The magnesium silicate hydrate sample outperformed the cement sample, in terms of stability in a high-concentration sulfate erosion environment, but it tended to degrade considerably more rapidly, and to a greater extent, than Portland cement, in both dry and wet sulfate cycle environments.
