Is Sarcopenia Related to Mortality in Patients with Chronic Obstructive Pulmonary Disease in the Intensive Care Unit?

Abstract

Introduction:On admission to the intensive care unit (ICU), functional and general health stata are important baseline characteristics of critically ill patients with chronic obstructive pulmonary disease (COPD). The measurement of total psoas muscle area (PMA) is under investigation to determine physical frailty and sarcopenia, especially encountered in the elderly, to predict adverse outcomes and mortality in patients requiring inhospital and ICU management. We aimed to assess the clinical value of total PMA for the prediction of mortality in COPD patients requiring ICU management of acute exacerbations.Methods:The clinical data of 62 patients whose abdominal computed tomography (CT) scans were available in the hospital Picture Archiving Communication System were collected. The mean duration of stay in the ICU was 7.7±8.8 and 9.4±12.3 days in survivors and non-survivors. The main causes of mortality in non-survivors were respiratory failure and cardiac arrest. For measurements from CT scans, images of the caudal end of the third lumbar vertebra were used. Right and left PMAs were measured to obtain the total PMA and density.Results:Of 62 patients, 20 (32.2%) were non-survivors (male: 13, female: 7), and 42 were survivors (male: 32, female: 10). There was no significant difference between non-survivors and survivors regarding total PMA and density values (p>0.05). In non-survivors and survivors, females had lower total PMA (p0.05).Conclusion:The total PMA lacks sufficient power to predict mortality in patients managed with acute exacerbations of COPD in intensive care settings. There is a need for further studies with different sets of findings to assess the contribution of physical frailty and sarcopenia to adverse outcomes in the ICU management of COPD patients.

Keywords

• chronic obstructive pulmonary disease
• copd
• frailty
• sarcopenia
• psoas muscle area
• computed tomography