Diagnosis of sarcopenia in mechanically ventilated patients and its impact on prognosis

doi:10.3877/cma.j.issn.1674-0785.2024.09.004

Abstract

Abstract:

Objective

To explore effective diagnostic methods for sarcopenia， its prevalence，and its impact on the prognosis of intensive care unit （ICU） patients receiving mechanical ventilation.

Methods

This study included 62 patients with respiratory failure who received mechanical ventilation in the ICU of Rudong Hospital Affiliated to Xinglin College， Nantong University between January 2021 and December 2023. The SARC-F questionnaire and the thoracic skeletal muscle index （SMI） to diagnose sarcopenia. Patients were divided into sarcopenia and non-sarcopenia groups based on the diagnosis results.Key variables， including age， gender， APACHE-II and SOFA scores at 24 and 72 hours after admission， NRS-2002 score at admission， 7-day gastrointestinal nutrition compliance rate， mechanical ventilation duration，ICU stay， and 28-day mortality rate， were compared between the two groups.

Results

Of the 62 patients，24 were diagnosed with sarcopenia， resulting in a prevalence rate of 38.7%. The sarcopenia group had significantly higher NRS-2002 score， 72-hour APACHE-II and SOFA scores， longer mechanical ventilation duration， extended ICU stay， and lower 7-day gastrointestinal nutrition compliance rate compared to the nonsarcopenia group （P＜0.05）.

Conclusion

The combination of the SARC-F questionnaire and thoracic SMI may help effectively diagnose sarcopenia in mechanically ventilated ICU patients. Sarcopenia is prevalent in this population and is associated with a poor prognosis， highlighting the need for early diagnosis， evaluation，and treatment to optimize patient outcomes.

Key words: SARC-F questionnaire, Thoracic skeletal muscle index, Sarcopenia, Mechanical ventilation, Intensive care

Chunfeng Liu, Zhaohui Xu, Hongwei Shi, Rong Chen, Tengfei Ma, Pengfei Li, Rong Yuan, Jianrong Chen, Aiming Xu. Diagnosis of sarcopenia in mechanically ventilated patients and its impact on prognosis[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(09): 820-825.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2024.09.004

https://zhlcyszz.cma-cmc.com.cn/EN/Y2024/V18/I09/820

Figures/Tables 2

指标	问题	评分
力量（S）	提起约5 kg重物时的困难程度	不困难0分，有点困难1分，很困难或者不可能2分。
帮助行走（A）	在辅助下步行穿过房间时的困难程度	不困难0分，有点困难1分，很困难或者不可能2分。
站起来（R）	从椅子或者床上困难程度	不困难0分，有点困难1分，很困难或者不可能2分。
爬楼梯（C）	爬10级楼梯的困难程度	不困难0分，有点困难1分，很困难或者不可能2分。
跌倒（F）	去年患者跌倒几次	没有0分，1～3次1分，4次以上2分。

组别	肌少症组（n=24）	非肌少症组（n=38）	t/χ²值	P值
APACHE-II评分（分， $\overset{ˉ}{x}$ ±s）
24 h	22.3±3.3	20.9±4.1	1.48	＞0.05
72 h	15.7±4.5	11.1±2.8	4.49	＜0.05
SOFA评分（分， $\overset{ˉ}{x}$ ±s）
24 h	12.6±2.6	12.2±3.1	0.55	＞0.05
72 h	9.6±1.9	7.1±3.4	3.71	＜0.05
NRS-2002评分（分， $\overset{ˉ}{x}$ ±s）	5.2±0.9	3.3±1.4	6.50	＜0.05
有创通气时间（d， $\overset{ˉ}{x}$ ±s）	10.9±3.2	6.5±1.7	6.21	＜0.05
无创通气时间（d， $\overset{ˉ}{x}$ ±s）	6.4±4.6	3.3±1.4	3.21	＜0.05
ICU住院时间（d， $\overset{ˉ}{x}$ ±s）	17.2±5.9	9.8±2.3	5.87	＜0.05
28 d病死率［例（%）］	6（25）	5（13.2）	0.71	＞0.05
7 d胃肠内营养达标率［例（%）］	24（66.7）	35（92.1）	4.9	＜0.05

组别	肌少症组（n=24）	非肌少症组（n=38）	t/χ²值	P值
APACHE-II评分（分， $\overset{ˉ}{x}$ ±s）
24 h	22.3±3.3	20.9±4.1	1.48	＞0.05
72 h	15.7±4.5	11.1±2.8	4.49	＜0.05
SOFA评分（分， $\overset{ˉ}{x}$ ±s）
24 h	12.6±2.6	12.2±3.1	0.55	＞0.05
72 h	9.6±1.9	7.1±3.4	3.71	＜0.05
NRS-2002评分（分， $\overset{ˉ}{x}$ ±s）	5.2±0.9	3.3±1.4	6.50	＜0.05
有创通气时间（d， $\overset{ˉ}{x}$ ±s）	10.9±3.2	6.5±1.7	6.21	＜0.05
无创通气时间（d， $\overset{ˉ}{x}$ ±s）	6.4±4.6	3.3±1.4	3.21	＜0.05
ICU住院时间（d， $\overset{ˉ}{x}$ ±s）	17.2±5.9	9.8±2.3	5.87	＜0.05
28 d病死率［例（%）］	6（25）	5（13.2）	0.71	＞0.05
7 d胃肠内营养达标率［例（%）］	24（66.7）	35（92.1）	4.9	＜0.05

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