Intensive care unit (ICU) survivors have reduced physical function likely due to skeletal muscle wasting and weakness acquired during critical illness. However, the contribution of pre-morbid muscle mass has not been elucidated. We aimed to examine the association between pre-ICU muscle mass and ICU admission risk. Secondary outcomes include the relationship between muscle mass and ICU outcomes. ICU admissions between June 1, 1998, and February 1, 2019, were identified among participants of Geelong Osteoporosis Study (GOS), a population-based cohort study. Cox proportional hazard regression models estimated hazard ratios (HR) for ICU admission across T-score strata and continuous values of DXA-derived lean mass measures of skeletal mass index (SMI, lean mass/body mass %) and appendicular lean mass corrected for height (ALM/h2, kg/m2). Multivariable regression was used to determine the relationship between lean mass and ICU outcomes. One hundred and eighty-six of 3126 participants enrolled in GOS were admitted to the ICU during the follow-up period. In adjusted models, lean mass was not predictive of ICU admission (SMI: HR 0.99 95%CI 0.97–1.01, p = 0.32; ALM/h2: HR 1.11 95%CI 0.94–1.31, p = 0.23), while greater appendicular lean mass was related to reduced 28-day mortality (ALM/h2 adjOR: 0.25, 95%CI 0.10–0.63, p = 0.003, SMI adjOR: 0.91, 95%CI 0.82–1.02, p = 0.09). Lean mass was not associated with ICU admission in this population-based cohort study; however, greater appendicular lean mass was associated with reduced mortality. This suggests pre-ICU muscle status may not predict development of critical illness but is associated with better survival after critical illness occurs.

中文翻译：

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瘦体重是重症监护病房入院的危险因素：一项观察性研究

重症监护病房 (ICU) 幸存者的身体机能下降可能是由于骨骼肌萎缩和危重疾病期间获得的虚弱。然而，尚未阐明病前肌肉质量的贡献。我们旨在检查ICU前肌肉质量与ICU入住风险之间的关联。次要结果包括肌肉质量与 ICU 结果之间的关系。1998 年 6 月 1 日至 2019 年 2 月 1 日期间入住 ICU 的患者是基于人群的队列研究吉朗骨质疏松症研究 (GOS) 的参与者。Cox 比例风险回归模型估计了 ICU 入住的风险比 (HR) 跨 T 分数层和 DXA 衍生的骨骼质量指数瘦体重测量值（SMI，瘦体重 / 体重 %）的连续值和针对身高校正的附肢瘦体重(ALM/h2, kg/m2)。多变量回归用于确定瘦体重与 ICU 结果之间的关系。在随访期间，GOS 登记的 3126 名参与者中有 186 人入住 ICU。在调整后的模型中，瘦体重不能预测入住 ICU（SMI：HR 0.99 95%CI 0.97-1.01，p = 0.32；ALM/h2：HR 1.11 95%CI 0.94-1.31，p = 0.23），而更大的阑尾瘦肉质量与 28 天死亡率降低有关（ALM/h2 adjOR：0.25，95%CI 0.10–0.63，p = 0.003，SMI adjOR：0.91，95%CI 0.82–1.02，p = 0.09）。在这项基于人群的队列研究中，瘦体重与入住 ICU 无关；然而，更大的阑尾瘦体重与死亡率降低有关。这表明ICU前肌肉状态可能无法预测危重疾病的发展，但与危重疾病发生后更好的生存相关。