Sarcopenia diagnosed by chest CT predicts long-term mortality in critically ill patients with exacerbation of chronic obstructive pulmonary disease

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-08-20 DOI:10.1016/j.ejrad.2025.112373

Xinyu Dai , Qiqiang Zhou , Qizheng Wang , Meng Wang , Weili Zhao , Qingtao Zhou , Ke Liu , Ning Lang , Ying Liang

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引用次数: 0

Abstract

Background

Sarcopenia is a prevalent comorbidity in patients with chronic obstructive pulmonary disease (COPD). We aimed to investigate the impact of sarcopenia diagnosed by chest CT on mortality in critically ill patients with exacerbation of COPD (ECOPD).

Methods

This retrospective study enrolled 148 patients hospitalized in the intensive care unit due to ECOPD from 2018 to 2023. Sarcopenia was defined by the skeletal muscle index measured at the 12th thoracic vertebra (T12) level on chest CT. Patients were categorized into the sarcopenia and non-sarcopenia groups. Hospitalization duration, short-term (30 and 90-day) and long-term (1-year and overall) COPD-related mortality and all-cause mortality were compared between the two groups. Cox regression analyses were conducted to recognize the risk factors for mortality, and a sarcopenia-based nomogram was developed.

Results

Eighty-four patients (56.76 %) with sarcopenia were identified through chest CT measurements. The 1-year COPD-related and all-cause mortality, as well as overall COPD-related and all-cause mortality, were significantly higher in the sarcopenia group than the non-sarcopenia group (19.05 % vs. 4.69 %, p = 0.010; 28.57 % vs. 6.25 %, p = 0.001; 33.33 % vs. 15.63 %, p = 0.015; 47.62 % vs. 29.69 %, p = 0.027, respectively). Multivariate Cox regression analyses revealed sarcopenia as a risk factor for 1-year (HR = 3.981 [1.137–13.938], p = 0.031) and overall (HR = 2.308 [1.310–4.065], p = 0.004) mortality. The sarcopenia-based nomogram demonstrated favorable prognostic performance.

Conclusions

Sarcopenia evaluated at the T12 level on chest CT may serve as a prognostic factor for predicting long-term mortality among critically ill patients with ECOPD.

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胸部CT诊断的骨骼肌减少症可预测慢性阻塞性肺疾病加重的危重患者的长期死亡率

背景：肌肉减少症是慢性阻塞性肺疾病（COPD）患者的常见合并症。我们的目的是研究胸部CT诊断的肌肉减少症对重症COPD （ECOPD）加重患者死亡率的影响。方法回顾性研究纳入2018 - 2023年重症监护病房因ECOPD住院的148例患者。通过胸部CT在第12胸椎（T12）水平测量骨骼肌指数来定义肌少症。将患者分为肌肉减少症组和非肌肉减少症组。比较两组患者住院时间、短期（30天和90天）和长期（1年和总）copd相关死亡率和全因死亡率。进行Cox回归分析以识别死亡率的危险因素，并开发了基于肌肉减少症的nomographic。结果84例肌肉减少症患者（56.76%）通过胸部CT检查确诊。肌少症组1年copd相关死亡率和全因死亡率，以及总copd相关死亡率和全因死亡率均显著高于非肌少症组（19.05%比4.69%,p = 0.010； 28.57%比6.25%,p = 0.001； 33.33%比15.63%,p = 0.015； 47.62%比29.69%,p = 0.027）。多因素Cox回归分析显示，肌肉减少症是1年死亡率（HR = 3.981 [1.137-13.938], p = 0.031）和总死亡率（HR = 2.308 [1.310-4.065], p = 0.004）的危险因素。基于肌少症的x线图显示预后良好。结论胸部CT T12水平肌少症可作为预测ECOPD危重患者长期死亡率的预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.