Impact of sarcopenic obesity on 30-day mortality in critically ill patients with intra-abdominal sepsis

Ji, Yun; Cheng, Baoli; Xu, Zhipeng; Ye, Hui; Lu, Weina; Luo, Xi; Fu, Shuiqiao; Fang, Xiangming

doi:10.1016/j.jcrc.2018.03.019

Cited by 59 publications

(111 citation statements)

References 29 publications

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“…19 In critically ill patients with intra-abdominal sepsis, the highest 30-day mortality was found among obese patients with LM. 20 However, we found no difference in mortality outcome among obese patients with low or normal muscularity (data not shown). This is probably due to our small sample size.…”

Section: Discussionmentioning

confidence: 58%

“…In a cancer population, obesity with LM was linked to poorer functional status and was an independent factor for mortality . In critically ill patients with intra‐abdominal sepsis, the highest 30‐day mortality was found among obese patients with LM . However, we found no difference in mortality outcome among obese patients with low or normal muscularity (data not shown).…”

Section: Discussionmentioning

confidence: 99%

“…Body mass index (BMI) categories are not able to predict muscularity in various population . Although studies had shown that higher BMI confers survival benefits in the critically ill patient population, others have found that LM is associated with poorer outcome among overweight or obese patietns . As Malaysia has the highest prevalence of overweight (men 43.8%, women 48.6%) and obesity (men 11.4%, women 16.7%) in the South East Asia region, the proportion of obese patients with LM is worthwhile to be explored …”

Section: Introductionmentioning

confidence: 99%

“…17 Although studies had shown that higher BMI confers survival benefits in the critically ill patient population, 18 others have found that LM is associated with poorer outcome among overweight or obese patietns. 19,20 As Malaysia has the highest prevalence of overweight (men 43.8%, women 48.6%) and obesity (men 11.4%, women 16.7%) in the South East Asia region, the proportion of obese patients with LM is worthwhile to be explored. 21 Therefore, the objectives of this study were to (1) establish the overall and sex-specific cutoff values that predict hospital mortality in an Asian critically ill population, (2) investigate the mortality prognostic value of LM (defined by SMI cutoff), (3) determine the association between BMI and the degree of muscularity, and (4) determine the proportion of overweight or obese patients with LM.…”

Section: Introductionmentioning

confidence: 99%

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Low Muscularity as Assessed by Abdominal Computed Tomography on Intensive Care Unit Admission Is Associated With Mortality in a Critically Ill Asian Population

Lee

Chan

et al. 2019

J Parenter Enteral Nutr

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Background Low muscularity (LM) is associated with high mortality in the Caucasian critically ill population. Muscularity can be accurately measured by the skeletal muscle index (SMI; cm2/m2) generated by computed tomography (CT). This study aimed to establish the overall and sex‐specific cutoff values that predict hospital mortality in an Asian critically ill population. Methods This single‐center, retrospective, observational study included patients aged ≥18 years with an abdominal CT conducted within 72 hours of admission to the intensive care unit. SMI generated from CT images at the level of the mid‐third lumbar vertebra were extracted from the medical records. Area under the receiver operating characteristic curves (AUC) was generated to determine the SMI cutoff values for hospital mortality. Association between LM (defined by SMI cutoff value) and hospital mortality was further evaluated by multivariable logistic regression. Results In a sample of 228 patients, the overall SMI cutoff value (cm2/m2) for hospital mortality was 42.0 (AUC: 0.637; sensitivity: 66.7%, specificity: 56.8%), whereas it was 46.5 in males and 35.3 in females. More males than females had LM (51.4% vs 37.5%), and >40% of overweight/obese patients had LM. Patients with LM were older and had a longer duration of mechanical ventilation and hospitalization. After adjusting for known confounders, LM independently predicted hospital mortality in the overall sample (adjusted odds ratio: 2.42; 95% CI 1.16–5.03; P = 0.003) and in both sexes. Conclusion This study established a set of SMI cutoff values that predict hospital mortality. LM is independently associated with hospital mortality.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low Muscularity as Assessed by Abdominal Computed Tomography on Intensive Care Unit Admission Is Associated With Mortality in a Critically Ill Asian Population

Lee

Chan

et al. 2019

J Parenter Enteral Nutr

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“…Thus, when analyzing S‐alb and hsCRP in relation to outcome in ESRD, body composition should be considered. It is likely that high CRP and low S‐Alb in part may reflect a state of obese sarcopenia , a condition associated with older age, sedentary life style, and a high mortality rate both in ESRD and other conditions . Indeed, abdominal fat deposition is linked to inflammation, PEW, and increased mortality risk in ESRD .…”

mentioning

confidence: 99%

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Mukai

Villafuerte

Qureshi

et al. 2018

Seminars in Dialysis

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Low serum albumin (S-Alb) is a frequent feature of end-stage renal disease (ESRD) that independently predicts mortality. Serum albumin has mainly been considered a biomarker of visceral protein and immunocompetence status, fundamental to nutritional assessment. However, low S-albumin level is associated with persistent systemic inflammation and many bodies of evidence show that S-Alb has a limited role as a marker of nutritional status. We reported that a low S-Alb concentration was an independent risk factor for poor outcome in ESRD only in the presence of systemic inflammation. Moreover, the relationships between inflammatory biomarkers and outcome are confounded also by alterations in body composition (such as obese sarcopenia) and oxidative stress. Taken together, S-Alb alone should not be used as a proxy of the nutritional status in a dialysis patient. Its association with dietary intake is poor and low S-Alb values are most often non-nutritional in origin. When analyzing S-Alb to predict mortality risk in ESRD, it should always be combined with measurement of hsCRP.

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Nutritional Considerations Prior to Surgery

Griffin

2023

Nutritional Management of the Surgical Patient

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Impact of sarcopenic obesity on 30-day mortality in critically ill patients with intra-abdominal sepsis

Cited by 59 publications

References 29 publications

Low Muscularity as Assessed by Abdominal Computed Tomography on Intensive Care Unit Admission Is Associated With Mortality in a Critically Ill Asian Population

Low Muscularity as Assessed by Abdominal Computed Tomography on Intensive Care Unit Admission Is Associated With Mortality in a Critically Ill Asian Population

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Nutritional Considerations Prior to Surgery

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