The use of computed tomography images as a prognostic marker in critically ill cancer patients

Toledo, Diogo Oliveira; Carvalho, Amanda M.; Oliveira, Amanda Maria Ribas Rosa de; Toloi, Jerusa Márcia; Silva, Aline C.; Farah, José Francisco de Mattos; Prado, Carla M.; Silva, João M.

doi:10.1016/j.clnesp.2018.03.122

Cited by 38 publications

(74 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As SMI may better represent the degree of muscularity, we used the SMI instead of SMA to improve the quantification of muscularity . Recently, Toledo et al defined LM as SMI < 41.2 cm 2 /m 2 in a single‐center study with 99 critically ill cancer patients in an ICU in Brazil . Similarly, our study defined LM as SMI < 42.00 cm 2 /m 2 .…”

Section: Discussionsupporting

confidence: 79%

“…Of note, the term “low muscularity” instead of sarcopenia is used in this study because by definition, sarcopenia includes the presence of reduced muscle strength and functionality, neither of which can be diagnosed in most critically ill patients . From the existing literature, the prevalence of LM in the ICU as measured by CT scan ranged between 38.4% and 71% . This wide range of prevalence is likely due to the different patient populations studied (elderly, cancer, or general critically ill patients) .…”

Section: Discussionmentioning

confidence: 62%

“…30,31 From the existing literature, the prevalence of LM in the ICU as measured by CT scan ranged between 38.4% and 71%. [4][5][6][7] This wide range of prevalence is likely due to the different patient populations studied (elderly, cancer, or general critically ill patients). [4][5][6][7] In our study, patients with LM were older and predominantly male.…”

Section: Discussionmentioning

confidence: 99%

“…Critically ill patients may lose about 18%–30% of their skeletal muscle mass within 10 days of admission to the intensive care unit (ICU) . Low muscularity (LM) and muscle wasting have been associated with various adverse outcomes such as prolonged duration of mechanical ventilation, infectious complications, and increased hospitalization and mortality risk in critically ill patients . However, a set of universally accepted cutoff values to identify patients with LM in the critically ill population is lacking (especially in the Asian population), and this hinders accurate risk assessment and effective intervention.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Low muscularity (LM) and muscle wasting have been associated with various adverse outcomes such as prolonged duration of mechanical ventilation, infectious complications, and increased hospitaliza-tion and mortality risk in critically ill patients. [4][5][6][7][8] However, a set of universally accepted cutoff values to identify patients with LM in the critically ill population is lacking (especially in the Asian population), and this hinders accurate risk assessment and effective intervention. To the best of our knowledge, such cutoff values have not been established among the critically ill Asian population.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

View full text Add to dashboard Cite

show abstract

Applying the Global Leadership Initiative on Malnutrition criteria in patients admitted with SARS‐CoV‐2 infection using computed tomography imaging

Sheean¹,

O’Connor²,

Joyce

et al. 2023

Nut in Clin Prac

View full text Add to dashboard Cite

BackgroundPatients with low muscle mass and acute SARS‐CoV‐2 infection meet the Global Leadership Initiative on Malnutrition (GLIM) etiologic and phenotypic criteria to diagnose malnutrition, respectively. However, available cut‐points to classify individuals with low muscle mass are not straightforward. Using computed tomography (CT) to determine low muscularity, we assessed the prevalence of malnutrition using the GLIM framework and associations with clinical outcomes.MethodsA retrospective cohort was conducted gathering patient data from various clinical resources. Patients admitted to the COVID‐19 unit (March 2020 to June 2020) with appropriate/evaluable CT studies (chest or abdomen/pelvis) within the first 5 days of admission were considered eligible. Sex‐ and vertebral‐specific skeletal muscle indices (SMI; cm2/m2) from healthy controls were used to determine low muscle mass. Injury‐adjusted SMI were derived, extrapolated from cancer cut‐points and explored. Descriptive statistics and mediation analyses were completed.ResultsPatients (n = 141) were 58.2 years of age and racially diverse. Obesity (46%), diabetes (40%), and cardiovascular disease (68%) were prevalent. Using healthy controls and injury‐adjusted SMI, malnutrition prevalence was 26% (n = 36/141) and 50% (n = 71/141), respectively. Mediation analyses demonstrated a significant reduction in the effect of malnutrition on outcomes in the presence of Acute Physiology and Chronic Health Evaluation II, supporting the mediating effects of severity of illness intensive care unit (ICU) admission, ICU length of stay, mechanical ventilation, complex respiratory support, discharge status (all P values = 0.03), and 28‐day mortality (P = 0.04).ConclusionsFuture studies involving the GLIM criteria should consider these collective findings in their design, analyses, and implementation.

show abstract

Nutritional treatment in the critically-ill complicated patient

Mérida

Martín

Rodríguez

2021

Nutrition and Bariatric Surgery

View full text Add to dashboard Cite

The use of computed tomography images as a prognostic marker in critically ill cancer patients

Cited by 38 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

Applying the Global Leadership Initiative on Malnutrition criteria in patients admitted with SARS‐CoV‐2 infection using computed tomography imaging

Nutritional treatment in the critically-ill complicated patient

Contact Info

Product

Resources

About