Índice musculoesquelético torácico como potencial predictor de mortalidad en los pacientes críticamente enfermos con obesidad: estudio piloto

Introduction

Sarcopenic obesity is characterized by decreased strength and low muscle mass and has been associated with increased disability and morbidity-mortality. This study aimed to evaluate low muscle mass as a potential independent predictor of mortality in critically ill patients. Measurement of muscle mass at the T12 level using the thoracic skeletal muscle index (SMI) was proposed as a diagnostic method. The objective was to determine the association between low SMI and mortality in critically ill obese patients in the intensive care unit (ICU).

Materials and methods

This was a pilot study involving obese adult patients admitted to the ICU over a five-month period. A specialist in imaging performed muscle area measurements at the T12 level using thoracic computed tomography to determine SMI, utilizing Carestream PACS software. Each patient's SMI was evaluated against various outcomes, including mortality, using the chi-square test and SPSS software.

Results

Thirteen patients were included, with a mean BMI of 34 kg/m². All patients had low muscle mass, with an average SMI of 22 cm²/m². Of these, 38.4% died during their ICU stay; however, no statistically significant relationship was found between mortality and low muscle mass.

Conclusions

Low muscle mass was observed in all obese patients admitted to the ICU. However, low SMI was found to have no relationship with mortality, ICU length of stay, duration of mechanical ventilation, kidney injury, or the need to renal replacement therapy. The frequency of sarcopenia was significantly higher in women. Due to the uniformity in low muscle mass identified in all patients, it was not possible to make comparisons between groups.