Lumbar skeletal muscle index derived from routine computed tomography exams predict adverse post-extubation outcomes in critically ill patients.
J Crit Care
; 44: 117-123, 2018 04.
Article
em En
| MEDLINE
| ID: mdl-29096229
ABSTRACT
PURPOSE:
To evaluate the effect of a skeletal muscle index derived from a routine CT image at the level of vertebral body L3 (L3SMI) on outcomes of extubated patients in the surgical intensive care unit. MATERIALS ANDMETHODS:
231 patients of a prospective observational trial (NCT01967056) who had undergone CT within 5days of extubation were included. L3SMI was computed using semi-automated segmentation. Primary outcomes were pneumonia within 30days of extubation, adverse discharge disposition and 30-day mortality. Secondary outcomes included re-intubation within 72h, total hospital costs, ICU length of stay (LOS), post-extubation LOS and total hospital LOS. Outcomes were analyzed using multivariable regression models with a priori-defined covariates height, gender, age, APACHE II score and Charlson Comorbidity Index.RESULTS:
L3SMI was an independent predictor of pneumonia (aOR 0.96; 95% CI 0.941-0.986; P=0.002), adverse discharge disposition (aOR 0.98; 95% CI 0.957-0.999; P=0.044) and 30-day mortality (aOR 0.94; 95% CI 0.890-0.995; P=0.033). L3SMI was significantly lower in re-intubated patients (P=0.024). Secondary analyses suggest that L3SMI is associated with total hospital costs (P=0.043) and LOS post-extubation (P=0.048).CONCLUSION:
The lumbar skeletal muscle index, derived from routine abdominal CT, is an objective prognostic tool at the time of extubation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
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Estado Terminal
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Músculo Esquelético
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Intubação Intratraqueal
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Crit Care
Assunto da revista:
TERAPIA INTENSIVA
Ano de publicação:
2018
Tipo de documento:
Article