Rapid Muscle Loss Negatively Impacts Survival in Critically Ill Patients With Cirrhosis

Sunmi Ju, Sun Mi Choi, Young Sik Park, Chang Hoon Lee, Sang Min Lee, Chul Gyu Yoo, Young Whan Kim, Sung Koo Han, Jinwoo Lee

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Purpose: To assess the impact of rapid muscle loss before admission to intensive care unit (ICU) in critically ill patients with cirrhosis. Materials and Methods: Patients with cirrhosis who had undergone 2 or more recent computed tomography scans before admission to the medical ICU were included. Muscle cross-sectional area at the level of the third lumbar vertebra was quantified using OsiriX software. The rate of muscle mass change and skeletal muscle index (SMI) were also calculated. Multivariable Cox proportional hazards regression was used to evaluate the association between muscle loss and mortality. Results: Among 125 patients, 113 (90.4%) patients were classified as having sarcopenia. The mean body mass index was 22.6 (3.9) kg/m2. Thirty-nine (31.2%) patients were within the normal range for muscle mass change, while 86 (68.8%) patients demonstrated rapid decline in muscle mass before admission to the ICU. Patients with rapid muscle loss showed high ICU mortality (59.3%) and in-hospital mortality (77.9%). Multivariate Cox analysis showed that ICU mortality and in-hospital mortality were independently associated with malignancy, Acute Physiology and Chronic Health Evaluation (APACHE) II score, SMI, and rapid muscle loss. Conclusion: Rapid muscle decline is correlated with increased ICU mortality and in-hospital mortality in critically ill patients with cirrhosis.

Original languageEnglish
Pages (from-to)663-671
Number of pages9
JournalJournal of Intensive Care Medicine
Volume35
Issue number7
DOIs
StatePublished - 1 Jul 2020

Keywords

  • intensive care unit
  • liver cirrhosis
  • mortality
  • muscles
  • sarcopenia

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