Sarcopaenia in surgical ICU predicts poor functional outcomes after discharge

19 Oct 2021
Sarcopaenia in surgical ICU predicts poor functional outcomes after discharge

Surgical intensive care unit (SICU) patients who develop sarcopaenia are more likely to experience poor functional outcomes after discharge, a recent Thailand study has found.

Researchers conducted a prospective, cohort study enrolling 120 SICU patients (mean age 75.0±7.6 years, 51.7 percent men). Muscle mass and strength were assessed through bioelectrical impedance vector analysis and handgrip- or manual-muscle-strength tests. The primary endpoint was functional outcome 1 month after discharge, evaluated using the Thai version of the Barthel index for activities of daily living (ADL).

Sarcopaenia, defined as a muscle mass-to-body weight ratio of <7.0 kg/m2 in men and <5.7 kg/m2 in women, was detected in 40 participants, corresponding to a prevalence rate of 33.3 percent.

Multivariate logistic regression analysis revealed that sarcopaenia more than tripled the likelihood of poor functional outcomes 1 month after discharge (adjusted odds ratio [OR], 3.33, 95 percent confidence interval, 1.25–8.87; p=0.016). A longer duration of mechanical ventilation (adjusted OR, 1.19, 95 percent CI, 1.02–1.38; p=0.024) and of hospital stay (adjusted OR, 1.05, 95 percent CI, 1.01–1.10; p=0.02) were likewise independent risk factors for poor functional outcomes.

Sarcopaenia also doubled the risk of 120-day mortality (adjusted hazard ratio [HR], 2.07, 95 percent CI, 1.02–4.22; p=0.045).

“The ability to early identify sarcopenia in ICU patients provided benefits to the prediction of treatment outcomes and to the implementation of strategies to prevent the development of ICU-acquired weakness,” the researchers said.

Asian J Surg 2021;doi:10.1016/j.asjsur.2021.09.012