Morphometric parameters of muscle and bone in critically ill patients : Post hoc analysis of the VITdAL-ICU trial.


Journal

Wiener klinische Wochenschrift
ISSN: 1613-7671
Titre abrégé: Wien Klin Wochenschr
Pays: Austria
ID NLM: 21620870R

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 20 05 2020
accepted: 12 08 2020
pubmed: 19 9 2020
medline: 16 6 2021
entrez: 18 9 2020
Statut: ppublish

Résumé

Sarcopenia, defined as loss of muscle mass, quality and function, is a part of the frailty syndrome. In critical illness, sarcopenia has rarely been evaluated regarding clinical outcomes. Therefore, we evaluated the association of sarcopenia with both hospital length of stay (HLOS) and 6‑month mortality in critically ill patients using abdominal computed tomography (CT) scans. In a post hoc analysis from the high dose vitamin D3 vs. placebo in adult vitamin D deficient patients (VITdAL-ICU) trial, we retrospectively reviewed all available abdominal CT scans (18 women, 19 men). We measured and calculated total psoas area (TPA), psoas muscle density (PMD), skeletal muscle index (SMI) and bone mineral density (BMD) and analyzed the relation of these endpoints with HLOS and mortality. Defining sarcopenia we used cut-off values for TPA as 642.1 mm Mean adjusted TPA was lower in women versus men (478 vs. 749 mm Although the study is limited by the small sample size, our data do not support a strong predictive value for TPA/PMD/SMI or BMD for HLOS or mortality in critically ill patients with vitamin D deficiency.

Sections du résumé

BACKGROUND BACKGROUND
Sarcopenia, defined as loss of muscle mass, quality and function, is a part of the frailty syndrome. In critical illness, sarcopenia has rarely been evaluated regarding clinical outcomes. Therefore, we evaluated the association of sarcopenia with both hospital length of stay (HLOS) and 6‑month mortality in critically ill patients using abdominal computed tomography (CT) scans.
METHODS METHODS
In a post hoc analysis from the high dose vitamin D3 vs. placebo in adult vitamin D deficient patients (VITdAL-ICU) trial, we retrospectively reviewed all available abdominal CT scans (18 women, 19 men). We measured and calculated total psoas area (TPA), psoas muscle density (PMD), skeletal muscle index (SMI) and bone mineral density (BMD) and analyzed the relation of these endpoints with HLOS and mortality. Defining sarcopenia we used cut-off values for TPA as 642.1 mm
RESULTS RESULTS
Mean adjusted TPA was lower in women versus men (478 vs. 749 mm
CONCLUSION CONCLUSIONS
Although the study is limited by the small sample size, our data do not support a strong predictive value for TPA/PMD/SMI or BMD for HLOS or mortality in critically ill patients with vitamin D deficiency.

Identifiants

pubmed: 32945947
doi: 10.1007/s00508-020-01736-4
pii: 10.1007/s00508-020-01736-4
pmc: PMC8195895
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

529-535

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Auteurs

Oliver Malle (O)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria. o.malle@gmx.at.

Dietmar Maurer (D)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

Doris Wagner (D)

Department of Surgery, Medical University of Graz, Graz, Austria.

Christian Schnedl (C)

Department of Interventional and Diagnostic Radiology, General Hospital of Klagenfurt, Graz, Austria.

Steven Amrein (S)

Department of Anesthesiology, Elisabethinen Hospital, Graz, Austria.

Thomas Pieber (T)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

Astrid Fahrleitner-Pammer (A)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

Hans Peter Dimai (HP)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

Karin Amrein (K)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

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