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Lean mass as a risk factor for intensive care unit admission: an observational study
PURPOSE: Intensive care unit (ICU) survivors have reduced physical function likely due to skeletal muscle wasting and weakness acquired during critical illness. However, the contribution of pre-morbid muscle mass has not been elucidated. We aimed to examine the association between pre-ICU muscle mas...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525013/ https://www.ncbi.nlm.nih.gov/pubmed/34663393 http://dx.doi.org/10.1186/s13054-021-03788-y |
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author | Thackeray, Matthew Mohebbi, Mohammadreza Orford, Neil Kotowicz, Mark A. Pasco, Julie A. |
author_facet | Thackeray, Matthew Mohebbi, Mohammadreza Orford, Neil Kotowicz, Mark A. Pasco, Julie A. |
author_sort | Thackeray, Matthew |
collection | PubMed |
description | PURPOSE: Intensive care unit (ICU) survivors have reduced physical function likely due to skeletal muscle wasting and weakness acquired during critical illness. However, the contribution of pre-morbid muscle mass has not been elucidated. We aimed to examine the association between pre-ICU muscle mass and ICU admission risk. Secondary outcomes include the relationship between muscle mass and ICU outcomes. METHODS: ICU admissions between June 1, 1998, and February 1, 2019, were identified among participants of Geelong Osteoporosis Study (GOS), a population-based cohort study. Cox proportional hazard regression models estimated hazard ratios (HR) for ICU admission across T-score strata and continuous values of DXA-derived lean mass measures of skeletal mass index (SMI, lean mass/body mass %) and appendicular lean mass corrected for height (ALM/h(2), kg/m(2)). Multivariable regression was used to determine the relationship between lean mass and ICU outcomes. RESULTS: One hundred and eighty-six of 3126 participants enrolled in GOS were admitted to the ICU during the follow-up period. In adjusted models, lean mass was not predictive of ICU admission (SMI: HR 0.99 95%CI 0.97–1.01, p = 0.32; ALM/h(2): HR 1.11 95%CI 0.94–1.31, p = 0.23), while greater appendicular lean mass was related to reduced 28-day mortality (ALM/h(2) adjOR: 0.25, 95%CI 0.10–0.63, p = 0.003, SMI adjOR: 0.91, 95%CI 0.82–1.02, p = 0.09). CONCLUSION: Lean mass was not associated with ICU admission in this population-based cohort study; however, greater appendicular lean mass was associated with reduced mortality. This suggests pre-ICU muscle status may not predict development of critical illness but is associated with better survival after critical illness occurs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-021-03788-y. |
format | Online Article Text |
id | pubmed-8525013 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-85250132021-10-22 Lean mass as a risk factor for intensive care unit admission: an observational study Thackeray, Matthew Mohebbi, Mohammadreza Orford, Neil Kotowicz, Mark A. Pasco, Julie A. Crit Care Research PURPOSE: Intensive care unit (ICU) survivors have reduced physical function likely due to skeletal muscle wasting and weakness acquired during critical illness. However, the contribution of pre-morbid muscle mass has not been elucidated. We aimed to examine the association between pre-ICU muscle mass and ICU admission risk. Secondary outcomes include the relationship between muscle mass and ICU outcomes. METHODS: ICU admissions between June 1, 1998, and February 1, 2019, were identified among participants of Geelong Osteoporosis Study (GOS), a population-based cohort study. Cox proportional hazard regression models estimated hazard ratios (HR) for ICU admission across T-score strata and continuous values of DXA-derived lean mass measures of skeletal mass index (SMI, lean mass/body mass %) and appendicular lean mass corrected for height (ALM/h(2), kg/m(2)). Multivariable regression was used to determine the relationship between lean mass and ICU outcomes. RESULTS: One hundred and eighty-six of 3126 participants enrolled in GOS were admitted to the ICU during the follow-up period. In adjusted models, lean mass was not predictive of ICU admission (SMI: HR 0.99 95%CI 0.97–1.01, p = 0.32; ALM/h(2): HR 1.11 95%CI 0.94–1.31, p = 0.23), while greater appendicular lean mass was related to reduced 28-day mortality (ALM/h(2) adjOR: 0.25, 95%CI 0.10–0.63, p = 0.003, SMI adjOR: 0.91, 95%CI 0.82–1.02, p = 0.09). CONCLUSION: Lean mass was not associated with ICU admission in this population-based cohort study; however, greater appendicular lean mass was associated with reduced mortality. This suggests pre-ICU muscle status may not predict development of critical illness but is associated with better survival after critical illness occurs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-021-03788-y. BioMed Central 2021-10-18 /pmc/articles/PMC8525013/ /pubmed/34663393 http://dx.doi.org/10.1186/s13054-021-03788-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Thackeray, Matthew Mohebbi, Mohammadreza Orford, Neil Kotowicz, Mark A. Pasco, Julie A. Lean mass as a risk factor for intensive care unit admission: an observational study |
title | Lean mass as a risk factor for intensive care unit admission: an observational study |
title_full | Lean mass as a risk factor for intensive care unit admission: an observational study |
title_fullStr | Lean mass as a risk factor for intensive care unit admission: an observational study |
title_full_unstemmed | Lean mass as a risk factor for intensive care unit admission: an observational study |
title_short | Lean mass as a risk factor for intensive care unit admission: an observational study |
title_sort | lean mass as a risk factor for intensive care unit admission: an observational study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525013/ https://www.ncbi.nlm.nih.gov/pubmed/34663393 http://dx.doi.org/10.1186/s13054-021-03788-y |
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