Feasibility, reliability, and clinical utility of skeletal muscle assessment with A-mode ultrasonography in hospitalized patients with burns

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2025-08-19 DOI:10.1016/j.burns.2025.107673

Frederiek G. Bosch , Harriët Jager-Wittenaar , Gretha C. Wesseling-Keuning , Jakob Hiddingh , Hans J. Eshuis , Cees P. van der Schans , Anuschka S. Niemeijer , Marianne K. Nieuwenhuis

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Abstract

Objectives

Amplitude-mode (A-mode) ultrasonography is a promising technique to monitor loss and recovery of skeletal muscle in patients with burns. However, its clinimetric properties are unknown. Therefore, we determined its feasibility, interrater, and intrarater reliability, and clinical utility.

Methods

Skeletal muscle thickness of upper arms and legs was assessed longitudinally in hospitalized adult patients with ≥ 5 % total body surface area (TBSA) burns, by pairs of two out of five raters. Feasibility was evaluated by % successful assessments, reliability by intra-class correlation coefficients (ICCs), and clinical utility by smallest detectable change (SDC).

Results

Thirty-four patients participated (77 % male; mean age 48 ± 17 y, median TBSA burned 12 % [IQR 7–19]). Images were acquired on 69 % of planned occasions, and 89 % of images could be analyzed. Overall interrater ICCs were ≥ 0.84 (for pairs: 0.63–0.99) and intrarater ICCs were ≥ 0.95 (for pairs: 0.45–0.99). The overall interrater SDC was ≤ 33 % of the measured mean (for pairs: 3–52 %), while intrarater SDC was ≤ 20 % (for pairs: 3–48 %). All five raters could measure legs with moderate to excellent reliability, whereas for arms some demonstrated poor reliability.

Conclusion

A-mode ultrasonography assessment of skeletal muscle in patients with burns is feasible. However, reliability and clinical utility are rater-dependent; therefore we recommend assessments by the same rater.

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a型超声对住院烧伤患者骨骼肌评估的可行性、可靠性和临床应用

目的超声振幅模式（a型）是一种很有前途的监测烧伤患者骨骼肌损失和恢复的技术。然而，其临床性质尚不清楚。因此，我们确定了其可行性，判读器，判读器内的可靠性和临床实用性。方法对住院成人烧伤≥ 5 %总体表面积（TBSA）烧伤患者的上臂和腿部骨骼肌厚度进行纵向评估，采用2 / 5评分法。可行性通过成功评估的百分比来评估，可靠性通过类内相关系数（ICCs）来评估，临床效用通过最小可检测变化（SDC）来评估。结果34例患者（男性77 %，平均年龄48 ± 17 y，中位TBSA烧伤12 % [IQR 7-19]）。在69% %的计划场合获得图像，89 %的图像可以分析。总体间区icc≥ 0.84（对：0.63-0.99），内区icc≥ 0.95（对：0.45-0.99）。整体评分间SDC≤ 33 %（成对：3-52 %），而评分内SDC≤ 20 %（成对：3-48 %）。所有五名评分者都能以中等到极好的可靠性测量腿部，而对于手臂，有些人表现出较差的可靠性。结论a型超声对烧伤患者骨骼肌的评估是可行的。然而，可靠性和临床效用是相当依赖的；因此，我们建议由同一评级机构进行评估。

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

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.