Abstract
Skeletal muscle wasting in the intensive care unit (ICU) has been associated with mortality, but it is unclear whether sarcopenia, defined by skeletal muscle mass and function, is useful for detailed risk stratification after ICU discharge. In this cohort study, 72 critically ill patients with an ICU stay of ≥48 h were identified. Skeletal muscle mass was assessed from the muscle thickness (MT) of the patients’ quadriceps using ultrasound images before ICU discharge. Skeletal muscle function was assessed from the patients’ muscle strength (MS) before ICU discharge according to the Medical Research Council sum score. A diagnosis of sarcopenia in the ICU was made in patients with low MT and low MS. The study endpoint was 1-year mortality. Sarcopenia in the ICU was diagnosed in 26/72 patients (36%). After adjusting for covariates in the Cox regression, sarcopenia in the ICU was significantly associated with 1-year mortality (hazard ratio 3.82; 95% confidence interval, 1.40–10.42). Sarcopenia in the ICU, defined by low skeletal muscle mass and function, was associated with 1-year mortality in survivors of critical illness. Skeletal muscle mass and function assessed at the bedside could be used to identify higher-risk patients in the ICU.
Highlights
Skeletal muscle wasting and the development of intensive care unit-acquired weakness (ICU-AW) dramatically affect mortality and mobility disability after ICU discharge [1,2,3]
We calculated the incremental information of adding muscle strength (MS) to muscle thickness (MT) with the use of net reclassification improvement (NRI) and integrated discrimination improvement (IDI), which were used to compare the accuracy of the models in more detail [23]
A diagnosis of sarcopenia in the ICU was made in 26/72 patients (36%)
Summary
Skeletal muscle wasting and the development of intensive care unit-acquired weakness (ICU-AW) dramatically affect mortality and mobility disability after ICU discharge [1,2,3]. Skeletal muscle mass at ICU admission has been associated with mortality [4,5,6]. The value of assessing skeletal muscle mass and function in ICU patients has been emphasized in recent years [7]. Sarcopenia is defined as the loss of skeletal muscle mass and function [8]. It is described as a predictive biomarker that can help identify the risk of mobility disability and prognosis in hospitalized patients [9]. Sarcopenia was defined by skeletal muscle mass alone, or laboratory data from previous studies among patients with critical illnesses
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