Cho Yongtak, Kim Eung Nam, You Je Sung, Han Minkyung, Park Yoo Seok
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Department of Emergency Medicine, Hanyang University Hospital, Seoul 04763, Republic of Korea.
Life (Basel). 2024 May 24;14(6):680. doi: 10.3390/life14060680.
Muscle mass depletion is associated with unfavorable outcomes in many diseases. However, its relationship with cardiac arrest outcomes has not been explored. This retrospective single-center study determined the relationship between muscle mass depletion and the neurological outcomes of patients with out-of-hospital cardiac arrest (OHCA) by measuring muscle mass at various locations. Adult patients with OHCA, who were treated with target temperature management, and who underwent abdominal or chest computed tomography (CT) within 3 months of the cardiac arrest were included. Skeletal muscle index (SMI) was measured at the third lumbar vertebra (L3) level, psoas muscle, fourth thoracic vertebra (T4) level, and pectoralis muscle. The Youden index was used to determine a low SMI based on sex-specific cutoff values. The outcome variables were "good neurological outcome" and "survival" at hospital discharge. Multivariable analyses revealed that patients with low T4 SMI level were significantly associated with good neurological outcomes at hospital discharge (odds ratio = 0.26, 95% confidence interval: 0.07-0.88, = 0.036). However, no significant differences were observed between good neurological outcomes and low SMI at the L3 level and psoas and pectoralis muscles; SMIs were not associated with survival at hospital discharge. T4 level SMI depletion was inversely associated with good neurological outcomes in patients with OHCA. Thoracic muscle depletion may be crucial for predicting the neurological outcomes in patients with OHCA and further investigation in larger prospective study is warranted.
肌肉量减少与许多疾病的不良预后相关。然而，其与心脏骤停预后的关系尚未得到探讨。这项回顾性单中心研究通过测量不同部位的肌肉量，确定了肌肉量减少与院外心脏骤停（OHCA）患者神经学预后之间的关系。纳入了接受目标温度管理治疗且在心脏骤停后3个月内接受腹部或胸部计算机断层扫描（CT）的成年OHCA患者。在第三腰椎（L3）水平、腰大肌、第四胸椎（T4）水平和胸大肌处测量骨骼肌指数（SMI）。使用约登指数根据性别特异性临界值确定低SMI。结局变量为出院时的“良好神经学预后”和“存活”。多变量分析显示，T4 SMI水平低的患者出院时具有良好神经学预后的显著相关性（比值比=0.26，95%置信区间：0.07-0.88，P=0.036）。然而，在L3水平以及腰大肌和胸大肌处，良好神经学预后与低SMI之间未观察到显著差异；SMI与出院时的存活无关。T4水平的SMI减少与OHCA患者的良好神经学预后呈负相关。胸肌减少可能对预测OHCA患者的神经学预后至关重要，有必要在更大规模的前瞻性研究中进行进一步调查。
