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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去脂体重作为入住重症监护病房的危险因素：一项观察性研究


重症监护病房 (ICU) 幸存者的身体功能下降可能是由于危重疾病期间出现的骨骼肌萎缩和虚弱所致。然而，病前肌肉质量的贡献尚未阐明。我们的目的是检查 ICU 前肌肉质量与 ICU 入院风险之间的关联。次要结果包括肌肉质量和 ICU 结果之间的关系。吉朗骨质疏松症研究 (GOS) 是一项基于人群的队列研究，在 1998 年 6 月 1 日至 2019 年 2 月 1 日期间入住 ICU 的患者进行了确定。 Cox 比例风险回归模型估计了跨 T 分数层的 ICU 入院风险比 (HR) 以及 DXA 衍生的骨骼质量指数（SMI，去脂质量/体重百分比）和根据身高校正的四肢去脂质量的连续值（ALM/h2、千克/平方米）。使用多变量回归来确定去脂体重和 ICU 结果之间的关系。随访期间，参加 GOS 的 3126 名参与者中，有 186 名被送入 ICU。在调整后的模型中，瘦体重并不能预测入住 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），而更大的阑尾瘦体重体重与 28 天死亡率降低相关（ALM/h2 调整后：0.25，95%CI 0.10-0.63，p = 0.003，SMI 调整后：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，更大的四肢瘦体重与死亡率降低相关。这表明重症监护室前的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。