Department of Nutrition and Dietetics, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey.
Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Neurocrit Care. 2024 Dec;41(3):916-924. doi: 10.1007/s12028-024-02017-y. Epub 2024 Jun 25.
Acute muscle wasting is common in critically ill patients, and this can lead to unfavorable clinical outcomes. The aim of this study was to identify factors associated with muscle wasting and to investigate the association between skeletal muscle wasting and prolonged hospital stay in critically ill patients with acute brain injury.
This single-center prospective observational study was conducted in critically ill patients with acute brain injury who stayed in the intensive care unit for at least 1 week. The rectus femoris cross-sectional area was measured via ultrasound at baseline and a week after the first assessment. Univariate and multivariate logistic regression analyses were performed to identify factors that predicted prolonged hospital stay.
A total of 86 patients were included in the study. Their mean age was 49.4 ± 16.9 years, 57% were male, and 46.5% had an admission diagnosis of subarachnoid hemorrhage. The percentage change in the rectus femoris cross-sectional area was 15.8% (95% confidence interval [CI] - 19.8% to - 12.0%; p < 0.001), and 57% of all patients had acute muscle wasting. According to the univariate analysis, there was a significant association between prolonged hospital stay and acute muscle wasting (odds ratio [OR] 3.677; 95% CI 1.487-9.043; p = 0.005), mechanical ventilation status (OR 3.600; 95% CI 1.455-8.904; p = 0.006), and Glasgow Coma Scale score (OR 0.888; 95% CI 0.808-0.976; p = 0.014) at intensive care unit admission. The multivariate analysis demonstrated that acute muscle wasting (OR 3.449; 95% CI 1.344-8.853; p = 0.010) was an independent risk factor for prolonged hospital stay.
There was considerable muscle wasting in critically ill patients with brain injuries over a 1-week period. Acute muscle wasting was associated with prolonged hospital stay in critically ill patients with acute brain injury.
危重症患者中常见急性肌肉消耗，这可导致不良的临床结局。本研究旨在确定与肌肉消耗相关的因素，并探讨急性脑损伤危重症患者骨骼肌消耗与住院时间延长的关系。
这是一项单中心前瞻性观察研究，纳入了在重症监护病房至少停留 1 周的急性脑损伤危重症患者。在基线和首次评估后一周，通过超声测量股直肌横截面积。采用单因素和多因素 logistic 回归分析来确定预测住院时间延长的因素。
共纳入 86 例患者，平均年龄为 49.4±16.9 岁，57%为男性，46.5%的入院诊断为蛛网膜下腔出血。股直肌横截面积的百分比变化为 15.8%（95%置信区间为-19.8%至-12.0%；p<0.001），所有患者中有 57%存在急性肌肉消耗。单因素分析显示，住院时间延长与急性肌肉消耗（比值比 [OR] 3.677；95%置信区间为 1.487-9.043；p=0.005）、机械通气状态（OR 3.600；95%置信区间为 1.455-8.904；p=0.006）和重症监护病房入院时格拉斯哥昏迷评分（OR 0.888；95%置信区间为 0.808-0.976；p=0.014）显著相关。多因素分析显示，急性肌肉消耗（OR 3.449；95%置信区间为 1.344-8.853；p=0.010）是急性脑损伤危重症患者住院时间延长的独立危险因素。
急性脑损伤危重症患者在 1 周内存在明显的肌肉消耗。急性肌肉消耗与急性脑损伤危重症患者的住院时间延长有关。
