The association between sarcopenia and functional outcomes after hospital discharge among critically ill surgical patients

Abstract

Summary: Background: To determine the association between sarcopenia in surgical intensive care unit (SICU) patients and long-term functional outcomes. Method: This prospective, cohort study enrolled patients aged >65 years admitted to SICUs at the tertiary care hospital. Their muscle mass and strength were measured by bioelectrical impedance vector analysis (BIVA) and handgrip-strength or manual-muscle-strength tests. The functional outcomes were evaluated with the Thai version of the Barthel index for activities of daily living (ADL). Results: 120 patients were enrolled. A multivariate analysis identified 3 independent predictors associated with poor functional outcomes (ADL scores ≤70) at one month after hospital discharge including sarcopenia (adjusted odds ratio [aOR]: 3.33; 95% confidence interval [CI]: 1.25–8.87); duration of mechanical ventilation (aOR: 1.19; 95% CI: 1.02–1.38); and length of hospital stay (aOR: 1.05; 95% CI: 1.01–1.10). Cox proportional-hazards regression models found that sarcopenia (adjusted hazard ratio [aHR]: 2.07; 95% CI: 1.02–4.22) and admission severity (aHR: 1.13; 95% CI: 1.04–1.23) were predictors of 120-day mortality. Conclusions: Sarcopenia was an independent predictor of poor functional outcomes at one month after hospital discharge.

Keywords

• Bioelectrical impedance vector analysis (BIVA)
• Functional outcomes
• Sarcopenia
• Surgical intensive care unit