Longitudinal changes in muscle mass after ICU discharge: A prospective observational cohort study

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-09-18 DOI:10.1016/j.clnu.2025.09.004

Martin Sundström Rehal , Cechael Sebghati Sparrfelt , Nicole Lajewska , Arabella Fischer , Kristina Kilsand , Johan Helleberg , Henrike Häbel , Olav Rooyackers

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引用次数: 0

Abstract

Background

There is limited published data describing patterns of muscle wasting after critical illness. Muscle ultrasound is a practical method to monitor changes in muscle mass after Intensive Care Unit (ICU) discharge. The aim of this study was to investigate longitudinal changes in muscle mass after ICU discharge in a group of mixed medical-surgical ICU patients.

Methods

Adult ICU patients (n = 42) with a minimum length of stay in ICU of 3 days were prospectively enrolled. Baseline measurements of quadriceps muscle layer thickness, Medical Research Council sum score, hand grip strength and indirect calorimetry were performed in conjunction with ICU discharge and repeated every 3–5 days until hospital discharge or up to 28 days. The primary outcome was change in muscle thickness over time. Secondary outcomes were changes in physical function. Outcomes were assessed using best-fit generalized linear mixed models according to the Akaike information criteria. Interactions between outcomes and relevant covariates were investigated for hypothesis-generating purposes.

Results

In the best-fit crude analysis model, a small but statistically significant change in muscle thickness over time (p = 0.0475) was observed. In exploratory covariate analysis, there was a strong interaction between body weight, female sex, low nutritional intake and increased loss of muscle thickness. Assessments of physical function improved over time. Female sex and ICU length of stay were identified as potential predictors of impaired physical recovery.

Conclusions

In this cohort of adult ICU patients, we did not find a relevant group-level change in muscle mass after ICU discharge. However, patients with poor nutritional intake and female sex may be at greater risk of muscle wasting after intensive care. Further studies are warranted to investigate the relevance of post-ICU nutrition and gender on recovery of muscle mass after critical illness.

Trial registration

This study was prospectively registered at ClinicalTrials.gov on 2022-09-02 (NCT05531305).

查看原文本刊更多论文

ICU出院后肌肉质量的纵向变化：一项前瞻性观察队列研究。

背景：描述危重疾病后肌肉萎缩模式的已发表数据有限。肌肉超声是监测重症监护病房（ICU）出院后肌肉质量变化的实用方法。本研究的目的是探讨一组内科-外科混合ICU患者出院后肌肉量的纵向变化。方法：前瞻性纳入最小住院时间为3天的成人ICU患者42例。在ICU出院时进行股四头肌肌层厚度、医学研究委员会总评分、手部握力和间接量热的基线测量，每3-5天重复一次，直到出院或最多28天。主要结果是肌肉厚度随时间的变化。次要结果是身体功能的改变。根据赤池信息标准，使用最佳拟合广义线性混合模型评估结果。为了产生假设，研究了结果和相关协变量之间的相互作用。结果：在最佳拟合的粗分析模型中，肌肉厚度随时间的变化很小，但有统计学意义（p = 0.0475）。在探索性协变量分析中，体重、女性性别、低营养摄入和肌肉厚度损失增加之间存在很强的相互作用。随着时间的推移，对身体功能的评估有所改善。女性性别和ICU住院时间被确定为身体恢复受损的潜在预测因素。结论：在这个成年ICU患者队列中，我们没有发现ICU出院后肌肉量的相关组水平变化。然而，营养摄入不良和女性患者在重症监护后肌肉萎缩的风险更大。需要进一步研究重症监护后营养和性别对重症患者肌肉质量恢复的相关性。试验注册：本研究已于2022-09-02 （NCT05531305）在ClinicalTrials.gov上前瞻性注册。

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

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.