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Long-term clinical outcomes in critically ill patients with sepsis and pre-existing low muscle mass: a retrospective cohort study.
- Source :
-
BMC Anesthesiology . 9/15/2023, Vol. 23 Issue 1, p1-11. 11p. - Publication Year :
- 2023
-
Abstract
- Purpose: Critically ill patients with sepsis account for significant disease morbidity and healthcare costs. Low muscle mass has been proposed as an independent risk factor for poor short-term outcomes, although its effect on long-term outcomes remains unclear. Methods: Retrospective cohort analysis of patients treated at a quaternary care medical center over 6 years (09/2014 - 12/2020). Critically ill patients meeting Sepsis-3 criteria were included, with low muscle mass defined by ≤ 5th percentile skeletal muscle index, measured at the L3 lumbar level (L3SMI) on Computed-Tomography (CT) scan (≤ 41.6 cm2/m2 for males and ≤ 32.0 cm2/m2 for females). L3SMI was calculated by normalizing the CT-measured skeletal muscle area to the square of the patient's height (in meters). Measurements were taken from abdominal/pelvic CT scan obtained within 7 days of sepsis onset. The prevalence of low muscle mass and its association with clinical outcomes, including in-hospital and one-year mortality, and post-hospitalization discharge disposition in survivors, was analyzed. Unfavorable post-hospitalization disposition was defined as discharge to a location other than the patient's home. Results: Low muscle mass was present in 34 (23%) of 150 patients, with mean skeletal muscle indices of 28.0 ± 2.9 cm2/m2 and 36.8 ± 3.3 cm2/m2 in females and males, respectively. While low muscle mass was not a significant risk factor for in-hospital mortality (hazard ratio 1.33; 95% CI 0.64 – 2.76; p = 0.437), it significantly increased one-year mortality after adjusting for age and illness severity using Cox multivariate regression (hazard ratio 1.9; 95% CI 1.1 – 3.2; p = 0.014). Unfavorable post-hospitalization discharge disposition was not associated with low muscle mass, after adjusting for age and illness severity in a single, multivariate model. Conclusion: Low muscle mass independently predicts one-year mortality but is not associated with in-hospital mortality or unfavorable hospital discharge disposition in critically ill patients with sepsis. [ABSTRACT FROM AUTHOR]
- Subjects :
- *SKELETAL muscle physiology
*STATURE
*CONFIDENCE intervals
*CRITICALLY ill
*MULTIVARIATE analysis
*AGE distribution
*HEALTH outcome assessment
*PATIENTS
*DISEASES
*MEDICAL care costs
*RETROSPECTIVE studies
*TERTIARY care
*REGRESSION analysis
*SEPSIS
*HOSPITAL mortality
*RISK assessment
*SEVERITY of illness index
*DESCRIPTIVE statistics
*RESEARCH funding
*COMPUTED tomography
*LONGITUDINAL method
*ABDOMINAL radiography
*PELVIS
*DISCHARGE planning
*PROPORTIONAL hazards models
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 23
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- BMC Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 171990801
- Full Text :
- https://doi.org/10.1186/s12871-023-02274-y