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Thoracic skeletal muscle quantification using computed tomography and prognosis of elderly ICU patients

 Sung Woo Moon  ;  Song Yee Kim  ;  Ji Soo Choi  ;  Ah Young Leem  ;  Su Hwan Lee  ;  Moo Suk Park  ;  Young Sam Kim  ;  Kyung Soo Chung 
 SCIENTIFIC REPORTS, Vol.11(1) : 23461, 2021-12 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Female ; Humans ; Intensive Care Units ; Male ; Muscle, Skeletal / physiopathology* ; Organ Dysfunction Scores ; Prognosis ; Respiration, Artificial / methods ; Retrospective Studies ; Thorax / physiopathology* ; Tomography, X-Ray Computed / methods
In elderly ICU patients, the prevalence of skeletal muscle loss is high. Longitudinal effect of thoracic muscles, especially in elderly ICU patients, are unclear although skeletal muscle loss is related with the short- and long-term outcomes. This study aimed to evaluate whether pectoralis muscle mass loss could be a predictor of prognosis in elderly ICU patients. We retrospectively evaluated 190 elderly (age > 70 years) patients admitted to the ICU. We measured the cross-sectional area (CSA) of the pectoralis muscle (PMCSA) at the fourth vertebral region. CT scans within two days before ICU admission were used for analysis. Mortality, prolonged mechanical ventilation, and longitudinal changes in Sequential Organ Failure Assessment (SOFA) scores were examined. PMCSA below median was significantly related with prolonged ventilation (odds ratio 2.92) and a higher SOFA scores during the ICU stay (estimated mean = 0.94). PMCSA below median was a significant risk for hospital mortality (hazards ratio 2.06). In elderly ICU patients, a low ICU admission PMCSA was associated with prolonged ventilation, higher SOFA score during the ICU stay, and higher mortality. Adding thoracic skeletal muscle CSA at the time of ICU admission into consideration in deciding the therapeutic intensity in elderly ICU patients may help in making medical decisions.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Moon, Sung Woo(문성우) ORCID logo https://orcid.org/0000-0001-9917-9802
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Choi, Ji Soo(최지수) ORCID logo https://orcid.org/0000-0003-2716-6775
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