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Background: Loss of muscle mass occurs rapidly during critical illness. It can often lead to weakness and fatigue, and it negatively affects quality of life. Despite the importance of understanding the incidence of clinically significant muscle wasting in critically ill patients, there have been few reports on this subject. This study aimed to assess the incidence of and identify risk factors associated with clinically significant loss of muscle mass in this patient population. Methods: This was a single-center observational study. Informed consent was obtained from all patients. We used ultrasound to determine the rectus femoris cross-sectional area (RFcsa) of each patient on their first and seventh days of treatment in the intensive care unit (ICU). The primary outcome of the study was the incidence of significant muscle wasting, which was defined as a greater or equal to 10% reduction in RFcsa from day 1 to day 7. SOFA score on day 7, length of artificial ventilation, ICU length of stay and twenty-eight-day mortality were evaluated as secondary outcomes. We used a logistic regression model to determine whether patient age, sex, BMI, frailty score, or medical history were significant risk factors for muscle wasting.Results: We screened an initial cohort of 1,293 patients and recruited 186 as study participants. Ultrasound measurements were completed in 104 patients. Sixty-two of these patients (59.6%) showed ≥10% decreases in RFcsa. Logistic regression analysis identified patient age as the sole risk factor associated with significant muscle wasting. While we detected no statistically significant differences associated with the secondary outcomes, the 28-day mortality rate almost doubled in the group of patients with significant wasting (30.6% versus 16.7%; p=0.165).Conclusions: Clinically significant muscle wasting was frequently observed in our cohort of critically ill adult patients. Patient age was identified as a risk factor for muscle wasting. The results of this study could be used to plan future studies that evaluate strategies to prevent muscle wasting and to improve the outcomes of critically ill patients.Trial registration: clinicaltrials.gov, NCT 03865095, date of registration: March 6, 2019. |
