Department of Intensive Care Unit, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, China; Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
Department of Intensive Care Unit, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, China.
Clin Nutr. 2024 Dec;43(12):209-217. doi: 10.1016/j.clnu.2024.10.035. Epub 2024 Oct 26.
Skeletal muscle density (SMD) is a valuable prognostic indicator in various conditions such as cancer, liver cirrhosis. Yet, the connection between SMD and intra-abdominal infection in individuals who have suffered abdominal injuries is still unclear. The purpose of this research is to examine how well SMD can predict intra-abdominal infection in patients who have suffered abdominal trauma.
Participants with abdominal injuries were included in this research from January 2015 to April 2023. Based on the sex-specific cut off values of SMD, the entire population was split into two categories. Prognostic factors were identified through logistic regression analysis. ROC was used to assess the predictive accuracy of SMD and its combinations with other biomarkers for clinical outcomes.
A total of 220 patients were ultimately included in the study. Patients in the group with low SMD exhibited a higher incidence of intra-abdominal infection, longer hospital stays, and increased hospital costs. In patients with abdominal trauma, low SMD was identified as a significant independent predictor of intra-abdominal infection (OR 2.397; 95 % CI 1.117-5.141, p = 0.025). Low SMD had a higher area under the curve (AUC) in ROC analysis compared to TRF, NRS2002 score, and APACHEII score for predicting intra-abdominal infection (AUC 0.70, 95 % CI 0.61-0.78, p = 0.002). Moreover, low SMD showed associations with clinical outcomes such as hospital stay length and costs (p < 0.01).
Low SMD is recognized as an independent risk factor for predicting intra-abdominal infections in this patient population. Notably, SMD is emerging as a novel predictor of abdominal infections in patients with abdominal trauma.
骨骼肌密度（SMD）是癌症、肝硬化等多种情况下有价值的预后指标。然而，SMD 与腹部创伤患者的腹腔内感染之间的关系尚不清楚。本研究旨在探讨 SMD 对腹部创伤患者腹腔内感染的预测能力。
本研究纳入了 2015 年 1 月至 2023 年 4 月期间的腹部损伤患者。根据 SMD 的性别特异性截断值，将整个人群分为两组。通过逻辑回归分析确定预后因素。ROC 用于评估 SMD 及其与其他生物标志物组合对临床结局的预测准确性。
最终共有 220 例患者纳入本研究。SMD 低值组患者的腹腔内感染发生率、住院时间和住院费用均较高。在腹部创伤患者中，低 SMD 是腹腔内感染的显著独立预测因子（OR 2.397；95%CI 1.117-5.141，p=0.025）。与 TRF、NRS2002 评分和 APACHEII 评分相比，SMD 在 ROC 分析中预测腹腔内感染的 AUC 更高（AUC 0.70，95%CI 0.61-0.78，p=0.002）。此外，低 SMD 与住院时间和费用等临床结局相关（p<0.01）。
在该患者人群中，低 SMD 被认为是预测腹腔内感染的独立危险因素。值得注意的是，SMD 正在成为腹部创伤患者腹部感染的新预测指标。
