Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot Study
IMPORTANCE:. Early risk assessment of functional decline in patients with sepsis is clinically challenging. Recently, there is increasing interest in the nonvolitional evaluation of skeletal muscle quality. OBJECTIVES:. The aim of this study was to assess the relationship between skeletal muscle qua...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-01-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000835 |
| _version_ | 1797947146429792256 |
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| author | Yuta Takahashi, PT, MSc Tomoyuki Morisawa, PT, PhD Hiroshi Okamoto, MD, MPH Noriko Matsumoto, RD, MSc Masakazu Saitoh, PT, PhD Tetsuya Takahashi, PT, PhD Toshiyuki Fujiwara, MD, PhD |
| author_facet | Yuta Takahashi, PT, MSc Tomoyuki Morisawa, PT, PhD Hiroshi Okamoto, MD, MPH Noriko Matsumoto, RD, MSc Masakazu Saitoh, PT, PhD Tetsuya Takahashi, PT, PhD Toshiyuki Fujiwara, MD, PhD |
| author_sort | Yuta Takahashi, PT, MSc |
| collection | DOAJ |
| description | IMPORTANCE:. Early risk assessment of functional decline in patients with sepsis is clinically challenging. Recently, there is increasing interest in the nonvolitional evaluation of skeletal muscle quality.
OBJECTIVES:. The aim of this study was to assess the relationship between skeletal muscle quality and functional decline after intensive care.
DESIGN, SETTING, AND PARTICIPANTS:. This pilot study was a single-center prospective observational study conducted from March 2021 to February 2022. We included consecutive patients with sepsis who were admitted to our ICU.
MAIN OUTCOMES AND MEASURES:. The primary outcome was hospital-acquired disability (HAD), which is defined as a decrease in the Barthel index score of at least 5 points from pre-hospital to hospital discharge. Muscle quality was assessed by: 1) muscle echogenicity with ultrasound and 2) phase angle (PhA) with bioelectrical impedance analysis, both of which were measured on ICU days less than 3, 3–5, 5–7, 7–10, and 10–14. We compared longitudinal changes in muscle echogenicity and PhA between the HAD and non-HAD groups using two-way repeated measures analysis of variance with mixed models.
RESULTS:. Among the 22 patients, 7 (31.8%) had HAD. Muscle echogenicity was higher in the HAD group than in the non-HAD group (p < 0.001); however, no interaction effects were found between the two groups (p = 0.189). PhA showed a main effect on each evaluation day in patients (p = 0.040) and a significant interaction effect between the groups, including an early decreased pattern in the HAD group (p = 0.036).
CONCLUSIONS AND RELEVANCE:. Higher muscle echogenicity and a decreased PhA pattern are related to HAD. Noninvasive assessment of muscle quality using ultrasound and bioelectrical impedance analysis may be useful in predicting the functional prognosis of patients with sepsis. |
| first_indexed | 2024-04-10T21:23:14Z |
| format | Article |
| id | doaj.art-d341d6978d144fbcaa7c6dc59b3a52c0 |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-04-10T21:23:14Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-d341d6978d144fbcaa7c6dc59b3a52c02023-01-20T02:33:54ZengWolters KluwerCritical Care Explorations2639-80282023-01-0151e083510.1097/CCE.0000000000000835202301000-00012Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot StudyYuta Takahashi, PT, MSc0Tomoyuki Morisawa, PT, PhD1Hiroshi Okamoto, MD, MPH2Noriko Matsumoto, RD, MSc3Masakazu Saitoh, PT, PhD4Tetsuya Takahashi, PT, PhD5Toshiyuki Fujiwara, MD, PhD61 Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.3 Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.4 Department of Critical Care Medicine, St. Luke’s International Hospital, Tokyo, Japan.5 Department of Nutrition, St. Luke’s International Hospital, Tokyo, Japan.3 Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.3 Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.1 Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.IMPORTANCE:. Early risk assessment of functional decline in patients with sepsis is clinically challenging. Recently, there is increasing interest in the nonvolitional evaluation of skeletal muscle quality. OBJECTIVES:. The aim of this study was to assess the relationship between skeletal muscle quality and functional decline after intensive care. DESIGN, SETTING, AND PARTICIPANTS:. This pilot study was a single-center prospective observational study conducted from March 2021 to February 2022. We included consecutive patients with sepsis who were admitted to our ICU. MAIN OUTCOMES AND MEASURES:. The primary outcome was hospital-acquired disability (HAD), which is defined as a decrease in the Barthel index score of at least 5 points from pre-hospital to hospital discharge. Muscle quality was assessed by: 1) muscle echogenicity with ultrasound and 2) phase angle (PhA) with bioelectrical impedance analysis, both of which were measured on ICU days less than 3, 3–5, 5–7, 7–10, and 10–14. We compared longitudinal changes in muscle echogenicity and PhA between the HAD and non-HAD groups using two-way repeated measures analysis of variance with mixed models. RESULTS:. Among the 22 patients, 7 (31.8%) had HAD. Muscle echogenicity was higher in the HAD group than in the non-HAD group (p < 0.001); however, no interaction effects were found between the two groups (p = 0.189). PhA showed a main effect on each evaluation day in patients (p = 0.040) and a significant interaction effect between the groups, including an early decreased pattern in the HAD group (p = 0.036). CONCLUSIONS AND RELEVANCE:. Higher muscle echogenicity and a decreased PhA pattern are related to HAD. Noninvasive assessment of muscle quality using ultrasound and bioelectrical impedance analysis may be useful in predicting the functional prognosis of patients with sepsis.http://journals.lww.com/10.1097/CCE.0000000000000835 |
| spellingShingle | Yuta Takahashi, PT, MSc Tomoyuki Morisawa, PT, PhD Hiroshi Okamoto, MD, MPH Noriko Matsumoto, RD, MSc Masakazu Saitoh, PT, PhD Tetsuya Takahashi, PT, PhD Toshiyuki Fujiwara, MD, PhD Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot Study Critical Care Explorations |
| title | Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot Study |
| title_full | Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot Study |
| title_fullStr | Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot Study |
| title_full_unstemmed | Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot Study |
| title_short | Relationship Between Skeletal Muscle Quality and Hospital-Acquired Disability in Patients With Sepsis Admitted to the ICU: A Pilot Study |
| title_sort | relationship between skeletal muscle quality and hospital acquired disability in patients with sepsis admitted to the icu a pilot study |
| url | http://journals.lww.com/10.1097/CCE.0000000000000835 |
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