Sex-Specific Analysis of Pre-existing Low Muscle Mass and Mortality in Critically Ill Patients
A cross-sectional study of 760 ICU patients investigated factors associated with pre-existing low muscle mass and its relationship with 28-day mortality, highlighting sex-specific prevalence differences.
This research examines the prevalence and prognostic significance of pre-existing low muscle mass in critically ill patients within an intensive care unit setting. Understanding these factors is critical for metabolic researchers and clinicians aiming to identify early risk stratification markers that may influence patient outcomes during acute illness.
The study employed a cross-sectional design involving 760 adult ICU patients, comprising 513 males and 247 females. Researchers utilized computed tomography (CT) scans to define pre-existing low muscle mass using sex-specific cutoffs. Statistical analysis included multivariable logistic regression, restricted cubic spline (RCS) analysis, and Cox proportional hazards models to assess associations while adjusting for potential confounders.
Key findings indicate that pre-existing low muscle mass prevalence was 34.0% overall, with notably higher rates observed in males (41.3%) compared to females (19.8%). Higher body mass index (BMI) demonstrated an inverse association with low muscle mass in both sexes. Additionally, high nutritional risk and elevated comorbidity burden were independently associated with increased odds of pre-existing low muscle mass.
Regarding mortality outcomes, exploratory analysis suggested a linear inverse relationship between BMI and low muscle mass that may plateau at higher BMI levels, though these threshold values require prospective validation. In males, unadjusted models indicated an association between low muscle mass and 28-day mortality; however, this association was attenuated after adjusting for confounding variables.
The authors conclude that BMI, nutritional risk assessment (NRS 2002), and comorbidity burden (aCCI) serve as key cross-sectional factors supporting early risk stratification upon ICU admission. These findings underscore the importance of sex-stratified analysis in metabolic research contexts. The study emphasizes that while these markers are useful for initial assessment, prospective validation is necessary to confirm threshold values and mortality associations.