The impact of sarcopenia and acute muscle mass loss on long‐term outcomes in critically ill patients with intra‐abdominal sepsis

Autor: Michael C. Cox, Matthew Booth, Gabriela Ghita, Zhongkai Wang, Anna Gardner, Russell B. Hawkins, Dijoia B. Darden, Christiaan Leeuwenburgh, Lyle L. Moldawer, Frederick A. Moore, Philip A. Efron, Steven Anton, Scott C. Brakenridge
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Cachexia, Sarcopenia and Muscle, Vol 12, Iss 5, Pp 1203-1213 (2021)
Druh dokumentu: article
ISSN: 2190-6009
2190-5991
DOI: 10.1002/jcsm.12752
Popis: Abstract Background Sarcopenia is a known risk factor for poor outcomes across many chronic diseases. The impact on outcomes of both pre‐existing sarcopenia and acute muscle wasting (AMW) in acute critical illness caused by sepsis remain unclear. Methods We conducted a prospective longitudinal cohort study of critically ill patients with intra‐abdominal sepsis utilizing abdominal computed tomography at sepsis onset to determine baseline skeletal muscle index (SMI). Biomarkers of inflammation and catabolism were measured through 28 days while hospitalized. We performed follow‐up evaluations of strength and physical function at 3, 6, and 12 months, with interval CT analyses at 3 and 12 months to evaluate changes in muscle mass. Measured clinical outcomes included development of chronic critical illness (≥14 days in intensive care with persistent organ dysfunction), long‐term functional status, and 1 year mortality. Results Among 47 sepsis patients enrolled (mean age 53 ± 14 years), half (n = 23; 49%) were sarcopenic at baseline. Overall, sepsis patients exhibited acute and persistent muscle wasting with an average 8% decrease in SMI from baseline at 3 months (P = 0.0008). Sarcopenic (SAR) and non‐sarcopenic (NSAR) groups were similar in regards to age and comorbidity burden. SAR patients had greater acute physiologic derangement (APACHE II, 18 vs. 12.5), higher incidence of multiple organ failure (57% vs. 17%), longer hospital (21 vs. 12 days) and intensive care unit length of stays (13 vs. 4 days), and higher inpatient mortality (17% vs. 0%; all P
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