Lumbar skeletal muscle index derived from routine computed tomography exams predict adverse post-extubation outcomes in critically ill patients

Journal of Critical Care
Georg FuchsFlorian J Fintelmann

Abstract

To evaluate the effect of a skeletal muscle index derived from a routine CT image at the level of vertebral body L3 (L3SMI) on outcomes of extubated patients in the surgical intensive care unit. 231 patients of a prospective observational trial (NCT01967056) who had undergone CT within 5days of extubation were included. L3SMI was computed using semi-automated segmentation. Primary outcomes were pneumonia within 30days of extubation, adverse discharge disposition and 30-day mortality. Secondary outcomes included re-intubation within 72h, total hospital costs, ICU length of stay (LOS), post-extubation LOS and total hospital LOS. Outcomes were analyzed using multivariable regression models with a priori-defined covariates height, gender, age, APACHE II score and Charlson Comorbidity Index. L3SMI was an independent predictor of pneumonia (aOR 0.96; 95% CI 0.941-0.986; P=0.002), adverse discharge disposition (aOR 0.98; 95% CI 0.957-0.999; P=0.044) and 30-day mortality (aOR 0.94; 95% CI 0.890-0.995; P=0.033). L3SMI was significantly lower in re-intubated patients (P=0.024). Secondary analyses suggest that L3SMI is associated with total hospital costs (P=0.043) and LOS post-extubation (P=0.048). The lumbar skeletal muscle index, deriv...Continue Reading

Associated Clinical Trials

Citations

Jul 4, 2019·Journal of Thoracic Imaging·Amelie S TroschelFlorian J Fintelmann
Jul 14, 2020·Current Opinion in Clinical Nutrition and Metabolic Care·Arnaldo Lopez-Ruiz, Kianoush Kashani
May 31, 2018·Current Opinion in Critical Care·Wilhelmus G P M LooijaardPeter J M Weijs
May 29, 2018·Journal of Nutrition and Metabolism·Carlos Alfredo Galindo MartínOctavio Augusto Lescas Méndez
Nov 2, 2019·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Wilhelmus G P M LooijaardPeter J M Weijs
Jan 17, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Elisabeth De WaelePaul E Wischmeyer
Mar 1, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Enrico FiaccadoriCristina Cuerda
Nov 29, 2020·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Kate FetterplaceAdam M Deane
Jun 20, 2021·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Andrea P Marshall
Jul 11, 2021·Interactive Cardiovascular and Thoracic Surgery·Hüseyin Ulaş ÇınarÖzgür İnce
Dec 11, 2019·The Annals of Thoracic Surgery·Maria Lucia L MadariagaFlorian J Fintelmann

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