Dataset Information

Rectus abdominis and rectus femoris muscle thickness in determining nutritional risk in critically ill patients: a prospective cohort study in Turkey.

ABSTRACT:

Objectives

Malnutrition is a clinical condition that is frequently seen in critically ill patients in the intensive care unit (ICU). Although there are many scoring systems and tools used to determine nutritional risk, those that can be used in critically ill patients in the ICU are very few. The scoring systems used are insufficient to identify ICU patients with malnutrition or at risk.Malnutrition is generally presented with a decrease in skeletal muscle mass and muscle strength. Therefore, in many recent studies, attention has been drawn to the relationship between nutritional status and loss of muscle mass.

Design

A cohort study.

Setting

Forty-five patients hospitalised in an anaesthesia ICU in Turkey were included in the study.

Participants

Patients aged 18 years and older.

Interventions

Demographic data of patients included in the study, and Nutritional Risk Screening 2002 (NRS-2002) and Modified Nutrition Risk in Critically ill (mNUTRIC) scores in the first 24 hours of ICU admission were noted. Rectus abdominis muscle (RAM) and rectus femoris muscle (RFM) thicknesses were measured by the same person (intensive care specialist) with ultrasonography (USG).

Outcome measures

Finding a quantitative and practical evaluation method by determining the correlation of measurement of RAM and RFM thickness with USG with NRS-2002 and mNUTRIC score, which are scoring systems used to assess nutritional risk.

Results

The performance of RAM and RFM thickness in determining nutritional status was evaluated by receiver operating characteristic (ROC) analysis. Area under the ROC curves were calculated as >0.7 for RFM and RAM measurements (p<0.05). Specificity and sensitivity percentages of RAM were found to be higher than RFM in determining nutritional status.

Conclusion

This study showed that RAM and RFM thickness measured by USG can be a reliable and easily applicable quantitative method that can be used to determine nutritional risk in the ICU.

SUBMITTER: Gursoy C

PROVIDER: S-EPMC10069567 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Rectus abdominis and rectus femoris muscle thickness in determining nutritional risk in critically ill patients: a prospective cohort study in Turkey.

Gürsoy Canan C Alkan Aslı A Kaya Çubuk Emine E Karcı Efsane E Yılmaz Hüseyin Oğuz HO Çakır Tümay T

BMJ open 20230330 3

<h4>Objectives</h4>Malnutrition is a clinical condition that is frequently seen in critically ill patients in the intensive care unit (ICU). Although there are many scoring systems and tools used to determine nutritional risk, those that can be used in critically ill patients in the ICU are very few. The scoring systems used are insufficient to identify ICU patients with malnutrition or at risk.Malnutrition is generally presented with a decrease in skeletal muscle mass and muscle strength. There ...[more]

PMID: 36997242

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Project description:The loss of muscle mass in post-critical COVID-19 outpatients is difficult to assess due to the limitations of techniques and the high prevalence of obesity. Ultrasound is an emerging technique for evaluating body composition. The aim is to evaluate sarcopenia and its risk factors, determining ultrasound usefulness as a potential tool for this purpose according to established techniques, such as the bioimpedance vector analysis (BIVA), handgrip strength, and timed up-and-go test. This is a transversal study of 30 post-critical COVID-19 outpatients. We evaluated nutritional status by ultrasound (Rectus Femoris-cross-sectional-area (RF-CSA), thickness, and subcutaneous-adipose-tissue), BIVA, handgrip strength, timed up-and-go test, and clinical variables during admission. According to The European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN&EASO) Consensus for Sarcopenic and Obesity, in terms of excess fat mass and decreased lean mass, the prevalence of class-1 sarcopenic obesity was 23.4% (n = 7), and class-2 sarcopenic obesity was 33.3% (n = 10) in our study. A total of 46.7% (n = 14) of patients had a handgrip strength below the 10th percentile, and 30% (n = 9) achieved a time greater than 10s in the timed up-and-go test. There were strong correlations between the different techniques that evaluated the morphological (BIVA, Ultrasound) and functional measurements of muscle. Intensive care unit stay, mechanical ventilation, and age all conditioned the presence of sarcopenia in COVID-19 outpatients (R2 = 0.488, p = 0.002). Predictive models for sarcopenic diagnosis based on a skeletal muscle index estimation were established by RF-CSA (R2 0.792, standard error of estimate (SEE) 1.10, p < 0.001), muscle-thickness (R2 0.774, SEE 1.14, p < 0.001), and handgrip strength (R2 0.856, SEE 0.92, p < 0.001). RF-CSA/weight of 5.3 cm2/kg × 100 was the cut-off value for predicting sarcopenia in post-critical COVID-19 outpatients, with 88.2 sensitivity and 69.2% specificity. More than half of the post-critical COVID-19 survivors had sarcopenic obesity and functional impairment of handgrip strength. Intensive care unit stay, age, and mechanical ventilation all predict sarcopenia. An ultrasound, when applied to the assessment of body composition in post-critical COVID-19 patients, provided the possibility of assessing sarcopenia in this population.

Dataset Information

Rectus abdominis and rectus femoris muscle thickness in determining nutritional risk in critically ill patients: a prospective cohort study in Turkey.

Objectives

Design

Setting

Participants

Interventions

Outcome measures

Results

Conclusion

Publications

Rectus abdominis and rectus femoris muscle thickness in determining nutritional risk in critically ill patients: a prospective cohort study in Turkey.

Similar Datasets

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