Validation of the sarcopenia index to assess muscle mass in the critically ill: A novel application of kidney function markers

被引:86
作者
Barreto, Erin F. [1 ,2 ]
Poyant, Janelle O. [3 ]
Coville, Hongchuan H. [4 ,5 ]
Dierkhising, Ross A. [6 ]
Kennedy, Cassie C. [2 ,7 ]
Gajic, Ognjen [7 ]
Nystrom, Erin M. [1 ]
Takahashi, Naoki [8 ]
Moynagh, Michael R. [8 ]
Kashani, Kianoush B. [7 ,9 ]
机构
[1] Mayo Clin, Dept Pharm, 200 1st St SW, Rochester, MN 55905 USA
[2] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, 200 1st St SW, Rochester, MN 55905 USA
[3] Tufts Med Ctr, Dept Pharm, 800 Washington St, Boston, MA 02111 USA
[4] North Florida Reg Med Ctr, Dept Internal Med, 6500 W Newberry Rd, Gainesville, FL 32605 USA
[5] Univ Cent Florida, Coll Med, Orlando, FL 32827 USA
[6] Mayo Clin, Div Biomed Stat & Informat, 200 1st St SW, Rochester, MN 55905 USA
[7] Mayo Clin, Div Pulm & Crit Care Med, 200 1st St SW, Rochester, MN 55905 USA
[8] Mayo Clin, Dept Radiol, 200 1st St SW, Rochester, MN 55905 USA
[9] Mayo Clin, Div Nephrol & Hypertens, 200 1st St SW, Rochester, MN 55905 USA
关键词
Cystatin C; Creatinine; Intensive care units; Sarcopenia; Frailty; Computed tomography; SERUM CYSTATIN-C; FRAILTY; PREVALENCE; CREATININE; MORTALITY; OBESITY; CANCER; RATIO;
D O I
10.1016/j.clnu.2018.05.031
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background & aims: Adverse outcomes for hospitalized patients with sarcopenia are well documented, and identification of patients at risk remains challenging. The sarcopenia index (SI), previously defined as (serum creatinine/serum cystatin C) x 100, could be an inexpensive, readily accessible, objective tool to predict muscle mass and risk for adverse clinical outcomes. The aim of this study was to assess the validity of the SI as a predictor of muscle mass. Methods: Retrospective study of critically ill adults admitted to Mayo Clinic from 2012 to 2015 with suspected sepsis and an available creatinine and serum cystatin C. Muscle surface area was quantified at the L3/4 vertebral level in patients with an abdominal CT scan (CTMSA). Multivariable regression modeling was used to assess the relationship between SI and CTMSA, as well as short-term clinical outcomes. Results: The 171 included had a mean weight and body mass index (BMI) of 75.2 +/- 16.4 kg and 26.0 +/- 4.6 kg/m(2) and abdominal CT scans were available for 81 (47%) patients. The SI correlated with CTMSA (r = 0.40). After adjustment for age, sex, severity of illness, and BMI, SI was independently associated with muscle mass (P = 0.001). A decrease in the SI (indicative of lower muscle mass) was also associated with frailty and worse short-term clinical outcomes. Conclusion: The SI, a simple calculation from kidney function markers, is a significant predictor of muscle mass in this validation cohort of ICU patients. A low SI was associated with longer hospital length of stay and frailty. Future studies could explore whether the use of SI assists with identifying patients likely to benefit from pharmacotherapy-, nutrition-, or physical therapy-based interventions. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
引用
收藏
页码:1362 / 1367
页数:6
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