Prognostic value of temporalis muscle thickness in intracerebral hemorrhage

Waldemar Gubarev¹Jan Klinke¹Ulrike Voßmann¹Daniel Cantré²Bijan Zendeh Zartoshti¹Artem Rafaelian³milos Arsenovic³Daniel Dubinski³Sae-Yeon Won³Florian Andreas Gessler⁴Thomas Freiman⁴Alexander Storch¹Matthias Wittstock^1*

• ¹Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany
• ²Institute of Diagnostic and Interventional Radiology, Pediatric Rdiology and Neuroradiology, Univeristy Medical Center Rostock, University of Rostock, Rostock, Germany
• ³Department of Neurosurgery, University Hospital Rostock, Rostock, Mecklenburg-Vorpommern, Germany
• ⁴Departmen of Neurosurgery, Universty Medical Center Rostock, University of Rostock, Rostock, Germany

Estimating the prognosis of spontaneous intracerebral hemorrhage (ICH) is of great importance. It has not been conclusively clarified whether sarcopenia is predictive for the functional outcome in ICH. Determining the temporalis muscle thickness (TMT) may be helpful for estimating sarcopenia. An association of TMT with outcome (mRS) has been shown in cerebellar ischemia and traumatic brain injury. The present retrospective study of 488 consecutive patients with ICH aimed to investigate the association of sarcopenia as assessed by TMT with mRS. In addition to biometric data, ICH subtype and severity (modified ICH score [mICH]), occurrence of complications and mRS at discharge and after 90 days were recorded. The influence of sarcopenia assessed by TMT as the surrogate marker using head imaging (cCT, cMRT) on mRS was analyzed by ordinal regression analysis. Dichotomization into sarcopenic and non-sarcopenic patients was carried out using standard threshold values. Finally, 322 patients were analyzed (median [IQR] age: 77 [66-83] years; 57.5% male). Sarcopenic patients were older (P<0.001), had lower BMI (P=0.025) and higher mICH scores (P<0.001) compared to nonsarcopenic patients. There was no significant difference in the overall distribution of mRS scores between sarcopenic and non-sarcopenic patients at discharge (unadjusted common OR: 1.28; 95%CI: 0.85-1.92; P=0.236), but at 90 days favoring the nonsarcopenic over the sarcopenic group (unadjusted common OR: 1.41; 95%CI: 1.07-2.12; P=0.049). The results did not survive statistical adjustment to candidate covariates by multivariate ordinal regression. In conclusion, sarcopenia as assessed by TMT seems to have limited prognostic value in ICH.