Background
Methods
Patients and data
CT scan analysis
Statistics
Results
Patient characteristics
All patients
N = 491 | Survivors1
(n = 299) | Non-survivors1
(n = 165) |
P value survivors vs. non-survivors | ||||
---|---|---|---|---|---|---|---|
Mean/median/n
| SD/IQR/% | Mean/median/n
| SD/IQR/% | Mean/median/n
| SD/IQR/% | ||
Age, years | 58 | ±18 | 55 | ±18 | 67 | ±14 |
<0.001
|
Sex, male, n (%) | 305 | 62% | 191 | 64% | 93 | 56% | 0.135 |
BMI, kg/m2
| 25.2 | ±4.3 | 25.5 | ±4.4 | 24.6 | ±4.3 |
0.042
|
Underweight2, n (%) | 19 | 4.1% | 11 | 3.7% | 8 | 4.8% | 0.291 |
Normal weight2, n (%) | 238 | 51.3% | 145 | 48.5% | 93 | 56.4% | |
Overweight2, n (%) | 158 | 34.1% | 108 | 36.1% | 50 | 30.3% | |
Obesity2, n (%) | 49 | 10.6% | 35 | 11.7% | 14 | 8.5% | |
APACHE II score | 24 | ±8 | 22 | ±8 | 27 | ±8 |
<0.001
|
Admission category, n (%) |
0.001
| ||||||
Medical | 248 | 50.5% | 130 | 43% | 102 | 62% | |
Surgical | 243 | 49.5% | 169 | 57% | 63 | 38% | |
Admission diagnosis, n (%) |
<0.001
| ||||||
Cardiovascular | 32 | 6.5% | 18a
| 6.0% | 14a
| 8.5% | |
Metabolic/renal | 15 | 3.1% | 8a
| 2.7% | 6a
| 3.6% | |
Neurologic | 41 | 8.4% | 19a
| 6.4% | 16a
| 9.7% | |
Post-resuscitation | 28 | 5.7% | 16a
| 5.4% | 11a
| 6.7% | |
Post-surgery | 149 | 30.3% | 95a
| 31.8% | 50a
| 30.3% | |
Respiratory insufficiency | 68 | 13.8% | 40a
| 13.4% | 25a
| 15.2% | |
Sepsis | 31 | 6.3% | 14a
| 4.7% | 15a
| 9.1% | |
Trauma | 94 | 19.1% | 74a
| 24.7% | 13b
| 7.9% | |
Other | 33 | 6.7% | 15a
| 5.0% | 15a
| 9.1% | |
Length of hospital stay before ICU admission, days | 0 | 0–4 | 0 | 0–4 | 0 | 0–6 | 0.166 |
Time from ICU admission to CT scan, days | 0 | 0–1 | 0 | 0–1 | 0 | 0–1 | 0.277 |
Skeletal muscle area, cm2
| 136.5 | ±39.0 | 143.5 | ±38.9 | 120.3 | ±33.0 |
<0.001
|
Skeletal muscle index, cm2/m2
| 44.8 | ±11.0 | 46.6 | ±10.6 | 40.4 | ±9.9 |
<0.001
|
Low skeletal muscle area3, n (%) | 312 | 63.5% | 163 | 54.5% | 137 | 83.0% |
<0.001
|
SMD, HU | 29.9 | ±11.7 | 31.4 | ±11.7 | 25.1 | ±9.4 |
<0.001
|
IMAT, cm2
| 13.6 | 8.4–24.3 | 13.3 | 7.9–23.2 | 17.1 | 10.5–27.1 |
0.004
|
Visceral adipose tissue, cm2 (n = 337) | 96.7 | 49.3–170.6 | 95.8 | 50.9–178.1 | 108.1 | 54.1–177.5 | 0.593 |
Subcutaneous adipose tissue, cm2 (n = 337) | 132.7 | 90.2–182.4 | 133.7 | 89.8–189.2 | 127.7 | 95.7–176.2 | 0.440 |
n
| % | Days | IQR | |
---|---|---|---|---|
Six-month mortality | 165 | 35.6% | ||
ICU mortality | 84 | 17.1% | ||
Hospital mortality | 132 | 26.9% | ||
Length of ventilation | 11 | 6–20 | ||
ICU length of stay | 13 | 7–23 | ||
Hospital length of stay | 35 | 19–59 | ||
Destination after discharge | ||||
Home | 144 | 40.7% | ||
Other hospital | 80 | 22.6% | ||
Nursing home | 76 | 21.5% | ||
Rehabilitation unit | 45 | 12.7% | ||
Other | 9 | 2.5% |
Association between muscle quality and 6-month mortality
Univariable
N = 491 | Model 2
N = 491 | Model 3
N = 491 | Model 4 (n = 337) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
6-month mortality | HR | 95% CI |
P value | HR | 95% CI |
P value | HR | 95% CI |
P value | HR | 95% CI |
P value |
SMD (per 10 HU) | 0.640 | 0.552–0.742 |
<0.001
| 0.703 | 0.605–0.818 |
<0.001
| 0.774 | 0.643–0.931 |
0.006
| 0.728 | 0.571–0.928 |
0.010
|
IMAT (per 10 cm2) | 1.153 | 1.042–1.277 |
0.006
| 1.092 | 0.980–1.217 | 0.110 | 1.092 | 0.966–1.236 | 0.159 | 1.244 | 1.048–1.476 |
0.012
|
Analyses in the subgroup with visceral and subcutaneous adipose tissue
Secondary outcome measures in survivors
Univariable | Model 2 | Model 3 | |||||||
---|---|---|---|---|---|---|---|---|---|
OR/B | 95% CI |
P value | OR/B | 95% CI |
P value | OR/B | 95% CI |
P value | |
Discharge to home | |||||||||
SMD (per 10 HU) | 1.039 | 0.864 to 1.250 | 0.683 | 0.990 | 0.816 to 1.200 | 0.915 | 0.926 | 0.718 to 1.195 | 0.556 |
IMAT (per 10 cm2) | 0.886 | 0.741 to 1.059 | 0.182 | 0.912 | 0.761 to 1.093 | 0.317 | 0.884 | 0.715 to 1.093 | 0.254 |
Length of ventilation | |||||||||
SMD (per 10 HU) | –0.038 | –0.107 to 0.032 | 0.292 | –0.003 | –0.075 to 0.069 | 0.936 | –0.018 | –0.111 to 0.075 | 0.705 |
IMAT (per 10 cm2) | 0.050 | –0.014 to 0.115 | 0.126 | 0.029 | –0.036 to 0.094 | 0.384 | 0.026 | –0.049 to 0.101 | 0.499 |
Length of ICU stay | |||||||||
SMD (per 10 HU) | –0.051 | –0.123 to 0.020 | 0.158 | –0.020 | –0.092 to 0.053 | 0.598 | –0.032 | –0.128 to 0.063 | 0.506 |
IMAT (per 10 cm2) | 0.064 | –0.003 to 0.130 | 0.059 | 0.043 | –0.023 to 0.110 | 0.199 | 0.041 | –0.036 to 0.119 | 0.292 |
Length of hospital stay | |||||||||
SMD (per 10 HU) | –0.123 | –0.192 to –0.054 |
0.001
| –0.112 | –0.184 to –0.041 |
0.002
| –0.134 | –0.228 to –0.040 |
0.005
|
IMAT (per 10 cm2) | 0.075 | 0.010 to 0.140 |
0.023
| 0.065 | –0.001 to 0.131 | 0.052 | 0.064 | –0.012 to 0.141 | 0.100 |