Department of Physical Medicine and Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, No.1492, Zhongshan Rd., Taoyuan Dist., Taoyuan, 330, Taiwan.
Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Sci Rep. 2022 Oct 5;12(1):16629. doi: 10.1038/s41598-022-21052-3.
Muscle atrophy greatly affects the prognosis of patients in the intensive care unit, but the rate of change remains unclear. In this prospective observational study, we used ultrasound to measure the change in muscle thickness of the rectus femoris (RF) and vastus intermedius (VI) in 284 patients who were admitted to the SICU of Taoyuan General Hospital between January 1 and June 30, 2020. Patients were excluded if there is a wound at the right thigh which hinders the ultrasonography probe from placing. Daily rates of muscle atrophy were calculated using linear analysis and the ratios of change were plotted against the period of hospitalization. Patient characteristics were adjusted using propensity score matching and differences between men and women were analyzed. A linear mixed model was used to calculate the influence of other factors on muscle loss. The average daily atrophy rates of the RF and VI were 0.84% and 0.98%, respectively. The rate of atrophy was the highest in the third and fourth weeks. Daily atrophy rates of the RF and VI were approximately three times higher in women than in men. Protective factors of muscle atrophy included higher BMI and lower initial thickness of the RF and VI. Our study depicts the trend of muscle atrophy in the ICU and suggests more discussion in prevention to be conducted especially for women.
肌肉萎缩极大地影响了重症监护病房(ICU)患者的预后,但变化的速度尚不清楚。在这项前瞻性观察研究中,我们使用超声测量了 2020 年 1 月 1 日至 6 月 30 日期间入住桃园总医院 SICU 的 284 名患者股直肌(RF)和股中间肌(VI)的肌肉厚度变化。如果右大腿有伤口妨碍超声探头放置,则将排除患者。使用线性分析计算肌肉萎缩的每日发生率,并将变化率与住院时间相对比。使用倾向评分匹配调整患者特征,并分析男女之间的差异。使用线性混合模型计算其他因素对肌肉损失的影响。RF 和 VI 的平均每日萎缩率分别为 0.84%和 0.98%。萎缩率在第三和第四周最高。女性的 RF 和 VI 每日萎缩率大约是男性的三倍。肌肉萎缩的保护因素包括较高的 BMI 和较低的 RF 和 VI 初始厚度。我们的研究描绘了 ICU 中肌肉萎缩的趋势,并建议特别针对女性进行更多的预防讨论。